Provider Demographics
NPI:1467872440
Name:PATEL, NILESH (RPH)
Entity Type:Individual
Prefix:MR
First Name:NILESH
Middle Name:
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 1:305 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07501-2102
Mailing Address - Country:US
Mailing Address - Phone:973-523-0777
Mailing Address - Fax:973-279-0489
Practice Address - Street 1:305 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-2102
Practice Address - Country:US
Practice Address - Phone:973-523-0777
Practice Address - Fax:973-279-0489
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02587700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist