Provider Demographics
NPI:1831479310
Name:BHAGADIA, MANAN S
Entity Type:Individual
Prefix:MR
First Name:MANAN
Middle Name:S
Last Name:BHAGADIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864-3116
Mailing Address - Country:US
Mailing Address - Phone:978-276-1380
Mailing Address - Fax:978-276-1386
Practice Address - Street 1:158 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH READING
Practice Address - State:MA
Practice Address - Zip Code:01864-3116
Practice Address - Country:US
Practice Address - Phone:978-276-1380
Practice Address - Fax:978-276-1386
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-28
Last Update Date:2011-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH24088183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist