Doctor Name: | MS. MANISHA GAUTAM |
NPI Number: | 1982094488 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 0230008055 |
Business Practice Address: | 13301 Gateway Center Dr Gainesville, VA - 201552984 |
Business Phone Number: | 5712615061 |
Business Fax Number: | 7034682149 |
Mailing Address: | 13301 Gateway Center Dr, GAINESVILLE |
State: | VA |
Postal Code: | 201552984 |
Phone Number: | 5712615061 |
Fax Number: | 7034682149 |
NPI Enumeration Date: | 02/04/2015 |
NPI Last Update Date: | 02/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 183700000X |
License Number: | 0230008055 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Pharmacy Service Providers |
Taxonomy Classification: | Pharmacy Technician |
Taxonomy Specialization: | |
Taxonomy Definition: | A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |