Provider Demographics
NPI:1245706779
Name:NAIK, DHYANA (PHARMD)
Entity type:Individual
Prefix:
First Name:DHYANA
Middle Name:
Last Name:NAIK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5865 SHELBY OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-7329
Mailing Address - Country:US
Mailing Address - Phone:901-516-0311
Mailing Address - Fax:901-516-0012
Practice Address - Street 1:5865 SHELBY OAKS CIR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-7329
Practice Address - Country:US
Practice Address - Phone:901-516-0311
Practice Address - Fax:901-516-0012
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist