Provider Demographics
NPI:1437562014
Name:PATEL, ANKIT
Entity Type:Individual
Prefix:
First Name:ANKIT
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 1:702 BROWNING LN
Mailing Address - Street 2:
Mailing Address - City:BROOKLAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08030-2645
Mailing Address - Country:US
Mailing Address - Phone:856-456-7141
Mailing Address - Fax:
Practice Address - Street 1:702 BROWNING LN
Practice Address - Street 2:
Practice Address - City:BROOKLAWN
Practice Address - State:NJ
Practice Address - Zip Code:08030-2645
Practice Address - Country:US
Practice Address - Phone:856-456-7141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03518300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist