Provider Demographics
NPI:1770866576
Name:PATEL, ANAND A (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANAND
Middle Name:A
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2635 WESTFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08105-1132
Mailing Address - Country:US
Mailing Address - Phone:856-966-1112
Mailing Address - Fax:856-966-1181
Practice Address - Street 1:2635 WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08105-1132
Practice Address - Country:US
Practice Address - Phone:856-966-1112
Practice Address - Fax:856-966-1181
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03349700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0062375Medicaid
NJ0062367Medicaid
NJ0062367Medicaid