Provider Demographics
NPI:1326648270
Name:PATEL, SANDHYA AJAY
Entity Type:Individual
Prefix:MRS
First Name:SANDHYA
Middle Name:AJAY
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 US HIGHWAY 9 N
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-1004
Mailing Address - Country:US
Mailing Address - Phone:732-826-6084
Mailing Address - Fax:732-826-6301
Practice Address - Street 1:360 US HIGHWAY 9 N
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-1004
Practice Address - Country:US
Practice Address - Phone:732-826-6084
Practice Address - Fax:732-826-6301
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02310600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist