Provider Demographics
NPI:1326457409
Name:PATEL, MANISHKUMAR
Entity Type:Individual
Prefix:
First Name:MANISHKUMAR
Middle Name:
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 1:1509 ROUTE 179
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08530-3447
Mailing Address - Country:US
Mailing Address - Phone:609-397-8889
Mailing Address - Fax:609-397-8383
Practice Address - Street 1:1509 ROUTE 179
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08530-3447
Practice Address - Country:US
Practice Address - Phone:609-397-8889
Practice Address - Fax:609-397-8383
Is Sole Proprietor?:No
Enumeration Date:2014-08-04
Last Update Date:2022-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03417900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist