Provider Demographics
NPI:1457635872
Name:GAJIPARA, MITA (PHARMD)
Entity Type:Individual
Prefix:
First Name:MITA
Middle Name:
Last Name:GAJIPARA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BUDD CT
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-3948
Mailing Address - Country:US
Mailing Address - Phone:973-932-4778
Mailing Address - Fax:
Practice Address - Street 1:45 EISENHOWER PKWY
Practice Address - Street 2:
Practice Address - City:ROSELAND
Practice Address - State:NJ
Practice Address - Zip Code:07068-1607
Practice Address - Country:US
Practice Address - Phone:973-364-7692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03415800183500000X
NJ28RJ03142183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist