Provider Demographics
NPI:1073854063
Name:SHETH, TRUSHAR (RPH)
Entity Type:Individual
Prefix:
First Name:TRUSHAR
Middle Name:
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:PO BOX 110
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-0110
Mailing Address - Country:US
Mailing Address - Phone:973-482-8220
Mailing Address - Fax:973-482-0615
Practice Address - Street 1:195 1ST AVE W
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-2618
Practice Address - Country:US
Practice Address - Phone:973-482-8220
Practice Address - Fax:973-482-0615
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02128100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist