Provider Demographics
NPI:1659683035
Name:SHAH, SHEETAL K (RPH)
Entity Type:Individual
Prefix:
First Name:SHEETAL
Middle Name:K
Last Name:SHAH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 ROYAL DR
Mailing Address - Street 2:APT 538
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3934
Mailing Address - Country:US
Mailing Address - Phone:781-223-2588
Mailing Address - Fax:
Practice Address - Street 1:123 MORRISTOWN RD
Practice Address - Street 2:
Practice Address - City:BERNARDSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07924-2337
Practice Address - Country:US
Practice Address - Phone:908-696-9202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03306900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist