Provider Demographics
NPI:1518210095
Name:VAGHELA, MANAN S (RPH,MS)
Entity Type:Individual
Prefix:MR
First Name:MANAN
Middle Name:S
Last Name:VAGHELA
Suffix:
Gender:M
Credentials:RPH,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 PERRY DR
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-5804
Mailing Address - Country:US
Mailing Address - Phone:443-934-1564
Mailing Address - Fax:
Practice Address - Street 1:970 PARKWAY AVE
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-2317
Practice Address - Country:US
Practice Address - Phone:609-882-3456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-20
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03443900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist