Provider Demographics
NPI:1033724026
Name:PATEL, AMI
Entity Type:Individual
Prefix:
First Name:AMI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2397
Mailing Address - Street 2:
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07096-2397
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:695 US HIGHWAY 46 STE 100
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-1561
Practice Address - Country:US
Practice Address - Phone:877-920-2090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY57874183500000X
TX60350183500000X
MD25201183500000X
VA0202216416183500000X
WVRP0010400183500000X
MI5302045258183500000X
OK17988183500000X
AL20609183500000X
LA22795183500000X
MST-15762183500000X
TN42814183500000X
KY020352183500000X
NE16359183500000X
NJ28RI03544600183500000X
KS1-14851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist