Provider Demographics
NPI:1427340967
Name:SHRESTHA, KUMUD (RPH)
Entity type:Individual
Prefix:
First Name:KUMUD
Middle Name:
Last Name:SHRESTHA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1781 STEFKO BLVD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-6241
Mailing Address - Country:US
Mailing Address - Phone:610-865-0761
Mailing Address - Fax:
Practice Address - Street 1:1781 STEFKO BLVD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-6241
Practice Address - Country:US
Practice Address - Phone:610-865-0761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP045014R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist