Provider Demographics
NPI:1104100056
Name:MEHRA-BATRA, NANDINI TINA (RPH)
Entity type:Individual
Prefix:MS
First Name:NANDINI
Middle Name:TINA
Last Name:MEHRA-BATRA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-5414
Mailing Address - Country:US
Mailing Address - Phone:860-885-0389
Mailing Address - Fax:860-889-2871
Practice Address - Street 1:399 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-5414
Practice Address - Country:US
Practice Address - Phone:860-885-0389
Practice Address - Fax:860-889-2871
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0008330183500000X
TX29078183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist