Provider Demographics
NPI:1770189128
Name:PATEL, HARSHA
Entity Type:Individual
Prefix:
First Name:HARSHA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ROONEY CIR
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-3304
Mailing Address - Country:US
Mailing Address - Phone:973-462-9623
Mailing Address - Fax:973-736-3487
Practice Address - Street 1:1 ROONEY CIR
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-3304
Practice Address - Country:US
Practice Address - Phone:973-462-9623
Practice Address - Fax:973-736-3487
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02081100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist