Provider Demographics
NPI:1578581229
Name:PATEL, JANAKKUMAR (RPH)
Entity Type:Individual
Prefix:MR
First Name:JANAKKUMAR
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 1:308 TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-3225
Mailing Address - Country:US
Mailing Address - Phone:908-463-3619
Mailing Address - Fax:908-527-1155
Practice Address - Street 1:308 TREMONT AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-3225
Practice Address - Country:US
Practice Address - Phone:908-463-3619
Practice Address - Fax:908-527-1155
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03002500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist