Provider Demographics
NPI:1710264767
Name:SHAH, BINDESH KIRAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:BINDESH
Middle Name:KIRAN
Last Name:SHAH
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 1:422 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514-1808
Mailing Address - Country:US
Mailing Address - Phone:973-345-3991
Mailing Address - Fax:973-345-0443
Practice Address - Street 1:422 10TH AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1808
Practice Address - Country:US
Practice Address - Phone:973-345-3991
Practice Address - Fax:973-345-0443
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI028470001835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy