Provider Demographics
NPI:1750836011
Name:VAIDYA, AKASH DATTU (PHARMD)
Entity type:Individual
Prefix:MR
First Name:AKASH
Middle Name:DATTU
Last Name:VAIDYA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 TINA DR
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-5778
Mailing Address - Country:US
Mailing Address - Phone:267-789-2111
Mailing Address - Fax:
Practice Address - Street 1:8828 FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19136-1313
Practice Address - Country:US
Practice Address - Phone:215-338-4010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP450029183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist