Provider Demographics
NPI:1164691333
Name:PATEL, PIYUSH K
Entity Type:Individual
Prefix:MR
First Name:PIYUSH
Middle Name:K
Last Name:PATEL
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 1:1495 UNION VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:WEST MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07480-1375
Mailing Address - Country:US
Mailing Address - Phone:973-728-1400
Mailing Address - Fax:973-728-0756
Practice Address - Street 1:1495 UNION VALLEY RD
Practice Address - Street 2:
Practice Address - City:WEST MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07480-1375
Practice Address - Country:US
Practice Address - Phone:973-728-1400
Practice Address - Fax:973-728-0756
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02783000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI02783000OtherRPH STATE LICENCE NUMBER