Provider Demographics
NPI:1861782708
Name:CHUDASAMA, HETAL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HETAL
Middle Name:
Last Name:CHUDASAMA
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 1:2709 WHITTLEBY CT
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-8185
Mailing Address - Country:US
Mailing Address - Phone:215-852-2528
Mailing Address - Fax:
Practice Address - Street 1:2709 WHITTLEBY CT
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-8185
Practice Address - Country:US
Practice Address - Phone:215-852-2528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442543183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist