Provider Demographics
NPI:1609237643
Name:MAHESHWARI, PRIYA
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:MAHESHWARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PRIYA
Other - Middle Name:
Other - Last Name:GOEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:642 WALLACE DR
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1912
Mailing Address - Country:US
Mailing Address - Phone:919-357-6416
Mailing Address - Fax:
Practice Address - Street 1:642 WALLACE DR
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-1912
Practice Address - Country:US
Practice Address - Phone:919-357-6416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-18
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18156183500000X
PARP455450183500000X
MI5302037068183500000X
TX51214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist