Provider Demographics
NPI:1992432181
Name:PATEL, KISHAN THAKOR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KISHAN
Middle Name:THAKOR
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 1:250 HIDDEN WOODS CT
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3062
Mailing Address - Country:US
Mailing Address - Phone:732-813-3005
Mailing Address - Fax:
Practice Address - Street 1:15 WOODBRIDGE CENTER DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-1312
Practice Address - Country:US
Practice Address - Phone:732-813-3005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-07
Last Update Date:2022-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI4212300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist