Provider Demographics
NPI:1295160455
Name:PATEL, KAJAAL BHASKER (RPH)
Entity type:Individual
Prefix:MRS
First Name:KAJAAL
Middle Name:BHASKER
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-4602
Mailing Address - Country:US
Mailing Address - Phone:908-277-2092
Mailing Address - Fax:908-277-2052
Practice Address - Street 1:364 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-4602
Practice Address - Country:US
Practice Address - Phone:908-277-2092
Practice Address - Fax:908-277-2052
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02509400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist