Provider Demographics
NPI:1124414347
Name:THAKKAR, ANKIT V
Entity Type:Individual
Prefix:
First Name:ANKIT
Middle Name:V
Last Name:THAKKAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 SAINT PAULS AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1622
Mailing Address - Country:US
Mailing Address - Phone:201-281-3180
Mailing Address - Fax:
Practice Address - Street 1:706 STATE ROUTE 15 S
Practice Address - Street 2:
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07849-2250
Practice Address - Country:US
Practice Address - Phone:973-663-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03698200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI03698200OtherPHARMACIST