Provider Demographics
NPI:1164971750
Name:THAKKAR, NILAY (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:NILAY
Middle Name:
Last Name:THAKKAR
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 N UNION AVE # 1
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-5101
Mailing Address - Country:US
Mailing Address - Phone:908-276-0062
Mailing Address - Fax:908-276-9450
Practice Address - Street 1:17 N UNION AVE # 1
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-5101
Practice Address - Country:US
Practice Address - Phone:908-276-0062
Practice Address - Fax:908-276-9450
Is Sole Proprietor?:No
Enumeration Date:2016-09-24
Last Update Date:2016-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03782900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist