Provider Demographics
NPI:1477870343
Name:RUDANI, SANJAYKUMAR K (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:SANJAYKUMAR
Middle Name:K
Last Name:RUDANI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:SANJAYKUMAR
Other - Middle Name:K
Other - Last Name:RUDANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:673 MAYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MAYWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07607-1505
Mailing Address - Country:US
Mailing Address - Phone:201-291-0059
Mailing Address - Fax:
Practice Address - Street 1:673 MAYWOOD AVE
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07607-1505
Practice Address - Country:US
Practice Address - Phone:201-291-0059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054463183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist