Provider Demographics
NPI:1790056497
Name:PRAJAPATI, CHETAL (RPH)
Entity Type:Individual
Prefix:MISS
First Name:CHETAL
Middle Name:
Last Name:PRAJAPATI
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 1:2251 EISENHOWER AVE
Mailing Address - Street 2:APT 1012
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-6900
Mailing Address - Country:US
Mailing Address - Phone:617-959-3088
Mailing Address - Fax:
Practice Address - Street 1:3101 DONNELL DR
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-3204
Practice Address - Country:US
Practice Address - Phone:301-778-1651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20487183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist