Provider Demographics
NPI:1114245115
Name:PATEL, VINOD I (RPH)
Entity Type:Individual
Prefix:
First Name:VINOD
Middle Name:I
Last Name:PATEL
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 1:7 SANTALINA DR
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-4130
Mailing Address - Country:US
Mailing Address - Phone:856-262-2298
Mailing Address - Fax:856-374-4693
Practice Address - Street 1:2 S BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-2951
Practice Address - Country:US
Practice Address - Phone:856-374-4602
Practice Address - Fax:856-374-4693
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02574600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist