Provider Demographics
NPI:1538537485
Name:GORADIA, GITA
Entity type:Individual
Prefix:MRS
First Name:GITA
Middle Name:
Last Name:GORADIA
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 1:20598 BILTMORE CT
Mailing Address - Street 2:
Mailing Address - City:POTOMAC FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:20165-3524
Mailing Address - Country:US
Mailing Address - Phone:703-939-2028
Mailing Address - Fax:
Practice Address - Street 1:20598 BILTMORE CT
Practice Address - Street 2:
Practice Address - City:POTOMAC FALLS
Practice Address - State:VA
Practice Address - Zip Code:20165-3524
Practice Address - Country:US
Practice Address - Phone:703-939-2028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202208340183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist