Provider Demographics
NPI:1124919824
Name:PATEL, PREEANKAA PARISHAA
Entity type:Individual
Prefix:
First Name:PREEANKAA
Middle Name:PARISHAA
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MAGNOLIA CT
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-5930
Mailing Address - Country:US
Mailing Address - Phone:312-890-7195
Mailing Address - Fax:
Practice Address - Street 1:2353 ROUTE 9
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1219
Practice Address - Country:US
Practice Address - Phone:312-890-7195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04441600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist