Provider Demographics
NPI:1922219120
Name:PATHAK, MUKTI (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MUKTI
Middle Name:
Last Name:PATHAK
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 1:300 CONSHOHOCKEN STATE RD STE 260
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-3820
Mailing Address - Country:US
Mailing Address - Phone:610-276-1298
Mailing Address - Fax:
Practice Address - Street 1:300 CONSHOHOCKEN STATE RD STE 260
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-3820
Practice Address - Country:US
Practice Address - Phone:610-276-1298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-28
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP437932183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist