Provider Demographics
NPI:1255761854
Name:PATEL, SNEHA M
Entity type:Individual
Prefix:
First Name:SNEHA
Middle Name:M
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3160 JOHN F KENNEDY BLVD
Mailing Address - Street 2:FL 2
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3524
Mailing Address - Country:US
Mailing Address - Phone:201-268-4277
Mailing Address - Fax:
Practice Address - Street 1:3160 JOHN F KENNEDY BLVD FL 2
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3524
Practice Address - Country:US
Practice Address - Phone:201-268-4277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03609400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist