Provider Demographics
NPI:1659030377
Name:VORA, AESHA
Entity Type:Individual
Prefix:
First Name:AESHA
Middle Name:
Last Name:VORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 E ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-4013
Mailing Address - Country:US
Mailing Address - Phone:980-505-5383
Mailing Address - Fax:
Practice Address - Street 1:1606 E ROOSEVELT BLVD STE 103
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-4049
Practice Address - Country:US
Practice Address - Phone:704-774-1313
Practice Address - Fax:704-774-1315
Is Sole Proprietor?:No
Enumeration Date:2021-12-09
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29394183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist