Provider Demographics
NPI:1184743486
Name:PATEL, HITENDRAKUMAR VITTHALBHAI (BS)
Entity type:Individual
Prefix:MR
First Name:HITENDRAKUMAR
Middle Name:VITTHALBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BUNNING DR
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4163
Mailing Address - Country:US
Mailing Address - Phone:718-702-7163
Mailing Address - Fax:856-983-1654
Practice Address - Street 1:160 N BROAD ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-1720
Practice Address - Country:US
Practice Address - Phone:856-251-1900
Practice Address - Fax:856-537-7861
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03048500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist