Provider Demographics
NPI:1184908634
Name:PATEL, DINESHKUMAR A
Entity type:Individual
Prefix:
First Name:DINESHKUMAR
Middle Name:A
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 1:21 ROYAL DR APT 141
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3190
Mailing Address - Country:US
Mailing Address - Phone:732-529-6493
Mailing Address - Fax:
Practice Address - Street 1:15 GREENWICH ST
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:NJ
Practice Address - Zip Code:07823-1449
Practice Address - Country:US
Practice Address - Phone:908-475-1060
Practice Address - Fax:908-475-1130
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2012-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03442200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist