Individual
DR. ROGER T ATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15622 N STATE ROAD 79, EDINBURGH, IN 46124-9276
(201) 982-0054
Mailing address
15622 N STATE ROAD 79, EDINBURGH, IN 46124-9276
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
26030070A
IN
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
26030070A
IN
1835P1200X
Pharmacotherapy Pharmacist
26030070A
IN
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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