Provider Demographics
NPI:1760763577
Name:GILL, JATINDER S (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JATINDER
Middle Name:S
Last Name:GILL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14525 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:EAST CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-3426
Mailing Address - Country:US
Mailing Address - Phone:216-851-1472
Mailing Address - Fax:216-851-1481
Practice Address - Street 1:14525 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:EAST CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-3426
Practice Address - Country:US
Practice Address - Phone:216-851-1472
Practice Address - Fax:216-851-1481
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03230468183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist