Provider Demographics
NPI:1033997291
Name:VAKIL, MOHINI (PHARMD)
Entity Type:Individual
Prefix:
First Name:MOHINI
Middle Name:
Last Name:VAKIL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 ROSEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07107-1757
Mailing Address - Country:US
Mailing Address - Phone:973-483-3872
Mailing Address - Fax:
Practice Address - Street 1:329 ROSEVILLE AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-1757
Practice Address - Country:US
Practice Address - Phone:201-952-3393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04255700183500000X
PARP456388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist