Provider Demographics
NPI:1821372509
Name:PATEL, JAYMIN (PHARMD, BA)
Entity Type:Individual
Prefix:DR
First Name:JAYMIN
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604-2514
Mailing Address - Country:US
Mailing Address - Phone:201-245-4392
Mailing Address - Fax:201-661-9660
Practice Address - Street 1:25 N SPRUCE ST
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1906
Practice Address - Country:US
Practice Address - Phone:201-661-9523
Practice Address - Fax:201-661-9660
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02932300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist