Provider Demographics
NPI:1790023034
Name:DAYA, KIRTI (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KIRTI
Middle Name:
Last Name:DAYA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 BAKER RD NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-4600
Mailing Address - Country:US
Mailing Address - Phone:678-331-8755
Mailing Address - Fax:
Practice Address - Street 1:2090 BAKER RD NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-4600
Practice Address - Country:US
Practice Address - Phone:678-331-8755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021117183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist