Provider Demographics
NPI:1497893358
Name:PATEL, PIUSHBHAI (RPH)
Entity Type:Individual
Prefix:MR
First Name:PIUSHBHAI
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 1:20 SPRUCE MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:MONROE TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-3103
Mailing Address - Country:US
Mailing Address - Phone:732-887-6111
Mailing Address - Fax:201-773-6667
Practice Address - Street 1:22-18 BROADWAY
Practice Address - Street 2:RETAIL STORE #5
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-3016
Practice Address - Country:US
Practice Address - Phone:201-773-6666
Practice Address - Fax:201-773-6667
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02985300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist