Provider Demographics
NPI:1790006906
Name:PATEL, MAUSAM M (PHARMD, RPH)
Entity Type:Individual
Prefix:MISS
First Name:MAUSAM
Middle Name:M
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 FLORHAM RD
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-3021
Mailing Address - Country:US
Mailing Address - Phone:973-945-0523
Mailing Address - Fax:
Practice Address - Street 1:68 US HIGHWAY 46 W
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-4978
Practice Address - Country:US
Practice Address - Phone:908-452-9252
Practice Address - Fax:908-452-9252
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03213700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist