Provider Demographics
NPI:1962113167
Name:ZAVERI, JISIT (PHARMD)
Entity type:Individual
Prefix:
First Name:JISIT
Middle Name:
Last Name:ZAVERI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9108 COLUMBIA AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2907
Mailing Address - Country:US
Mailing Address - Phone:219-462-0014
Mailing Address - Fax:219-462-0019
Practice Address - Street 1:9108 COLUMBIA AVE STE B
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2907
Practice Address - Country:US
Practice Address - Phone:219-462-0014
Practice Address - Fax:219-462-0019
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-08
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS53949183500000X
IL051294264183500000X
IN26023700A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist