Provider Demographics
NPI:1023600640
Name:PATEL, NIRAV YATIN
Entity type:Individual
Prefix:
First Name:NIRAV
Middle Name:YATIN
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 RAHWAY AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-1902
Mailing Address - Country:US
Mailing Address - Phone:908-965-2118
Mailing Address - Fax:908-282-1708
Practice Address - Street 1:214 RAHWAY AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-1902
Practice Address - Country:US
Practice Address - Phone:908-965-2118
Practice Address - Fax:908-282-1708
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02907400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist