Provider Demographics
NPI:1780994087
Name:TATA, ASHA LAKSHMI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ASHA
Middle Name:LAKSHMI
Last Name:TATA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:22 SOUTH GREENE STREET
Mailing Address - Street 2:N11E02
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201
Mailing Address - Country:US
Mailing Address - Phone:410-328-6108
Mailing Address - Fax:410-328-6781
Practice Address - Street 1:22 SOUTH GREENE STREET
Practice Address - Street 2:N11E02
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201
Practice Address - Country:US
Practice Address - Phone:410-328-6108
Practice Address - Fax:410-328-6781
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD185091835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist