Provider Demographics
NPI:1851514137
Name:PATEL, SMITA GIRISH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SMITA
Middle Name:GIRISH
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 STRAWBERRY CT
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2761
Mailing Address - Country:US
Mailing Address - Phone:732-317-4356
Mailing Address - Fax:
Practice Address - Street 1:913 MAIN AVE STE B
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-8540
Practice Address - Country:US
Practice Address - Phone:973-470-0556
Practice Address - Fax:973-470-0593
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03001300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI03001300OtherPHARMACIST