Provider Demographics
NPI:1174657506
Name:ISRANI, PRIYA (RPH)
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:ISRANI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6050 KENNEDY BLVD E
Mailing Address - Street 2:APT #11H
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-3901
Mailing Address - Country:US
Mailing Address - Phone:201-662-7757
Mailing Address - Fax:
Practice Address - Street 1:8416 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-4265
Practice Address - Country:US
Practice Address - Phone:201-869-5990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02573400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist