Provider Demographics
NPI:1225624422
Name:PATEL, VAISHALI S (RPH)
Entity Type:Individual
Prefix:
First Name:VAISHALI
Middle Name:S
Last Name:PATEL
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 1:281 STATE ROUTE 10 E
Mailing Address - Street 2:
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1375
Mailing Address - Country:US
Mailing Address - Phone:973-584-4466
Mailing Address - Fax:973-584-4648
Practice Address - Street 1:281 STATE ROUTE 10 E
Practice Address - Street 2:
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1378
Practice Address - Country:US
Practice Address - Phone:973-584-4466
Practice Address - Fax:973-584-4648
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-12
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02363400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist