Provider Demographics
NPI:1912767369
Name:NAST, TEJAL
Entity Type:Individual
Prefix:
First Name:TEJAL
Middle Name:
Last Name:NAST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 LEAS WAY
Mailing Address - Street 2:
Mailing Address - City:HATFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19440-2628
Mailing Address - Country:US
Mailing Address - Phone:267-664-2061
Mailing Address - Fax:
Practice Address - Street 1:1530 COWPATH RD
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:PA
Practice Address - Zip Code:19440-3101
Practice Address - Country:US
Practice Address - Phone:267-664-2061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP445892183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist