Provider Demographics
NPI:1043202336
Name:SHETH, BIPIN R (RPH)
Entity Type:Individual
Prefix:MR
First Name:BIPIN
Middle Name:R
Last Name:SHETH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 BENNINGTON TER
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1335
Mailing Address - Country:US
Mailing Address - Phone:718-220-2014
Mailing Address - Fax:718-220-2014
Practice Address - Street 1:2434 JEROME AVE
Practice Address - Street 2:C/O K & G PHARMACY, INC.
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-6401
Practice Address - Country:US
Practice Address - Phone:718-220-2014
Practice Address - Fax:844-304-2611
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00806859Medicaid
NY00806859Medicaid