Provider Demographics
NPI:1659695369
Name:PANDYA, NIRAV (PHARM D)
Entity Type:Individual
Prefix:
First Name:NIRAV
Middle Name:
Last Name:PANDYA
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 RIVENDELL WAY
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2075
Mailing Address - Country:US
Mailing Address - Phone:732-572-2462
Mailing Address - Fax:
Practice Address - Street 1:4041 HADLEY RD STE M
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-1111
Practice Address - Country:US
Practice Address - Phone:908-222-1011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03316800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist