Provider Demographics
NPI:1346519204
Name:PATEL, NITANG B (RPH)
Entity Type:Individual
Prefix:MR
First Name:NITANG
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 MONTROSE AVENUE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-2601
Mailing Address - Country:US
Mailing Address - Phone:908-668-6800
Mailing Address - Fax:908-668-1350
Practice Address - Street 1:615 MONTROSE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-2601
Practice Address - Country:US
Practice Address - Phone:908-668-6800
Practice Address - Fax:908-668-1350
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02568000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI02568000OtherSTATE OF NEW JERSEY