Provider Demographics
NPI:1033422647
Name:PATEL, JASMINE V (PHARMACIST)
Entity Type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:V
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08879-1536
Mailing Address - Country:US
Mailing Address - Phone:973-200-3695
Mailing Address - Fax:
Practice Address - Street 1:960 US HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:SOUTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08879-3310
Practice Address - Country:US
Practice Address - Phone:732-721-4101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-24
Last Update Date:2010-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03056900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist