Provider Demographics
NPI:1710325790
Name:PATEL, VINOD C
Entity Type:Individual
Prefix:
First Name:VINOD
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 ROUTE 23
Mailing Address - Street 2:PLAINS PHARMACY
Mailing Address - City:FRANKLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:07416
Mailing Address - Country:US
Mailing Address - Phone:973-827-7107
Mailing Address - Fax:973-827-8122
Practice Address - Street 1:66 ROUTE 23
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NJ
Practice Address - Zip Code:07416
Practice Address - Country:US
Practice Address - Phone:973-827-7107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01486400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4331800Medicaid
0751970001Medicare NSC