Provider Demographics
NPI:1518015130
Name:PATEL, NIKHIL (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:NIKHIL
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 SUNNY CT
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5224
Mailing Address - Country:US
Mailing Address - Phone:732-763-2705
Mailing Address - Fax:
Practice Address - Street 1:2240 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-2904
Practice Address - Country:US
Practice Address - Phone:212-534-1937
Practice Address - Fax:212-534-5065
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038187183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI02025000OtherPHARMACIST
NY01313139Medicaid
NY038187OtherPHARMACIST