Provider Demographics
NPI:1659588564
Name:KHANDWALA, NITIN (RPH)
Entity Type:Individual
Prefix:MR
First Name:NITIN
Middle Name:
Last Name:KHANDWALA
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 1:7 YALE CT
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1519
Mailing Address - Country:US
Mailing Address - Phone:973-202-0239
Mailing Address - Fax:
Practice Address - Street 1:7 YALE CT
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-1519
Practice Address - Country:US
Practice Address - Phone:973-202-0239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01716600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist