Provider Demographics
NPI:1477161826
Name:PATEL, AMMIE J (PHARMD, BCACP)
Entity Type:Individual
Prefix:DR
First Name:AMMIE
Middle Name:J
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD, BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 PEASE RD
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-2642
Mailing Address - Country:US
Mailing Address - Phone:732-986-1911
Mailing Address - Fax:
Practice Address - Street 1:222 COLUMBIA TPKE
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1299
Practice Address - Country:US
Practice Address - Phone:973-261-9077
Practice Address - Fax:973-593-2060
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI038077001835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care