Provider Demographics
NPI:1669565164
Name:GANDHI, PARESH THAKORBHAI (RPH)
Entity type:Individual
Prefix:MR
First Name:PARESH
Middle Name:THAKORBHAI
Last Name:GANDHI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:PARESH
Other - Middle Name:T
Other - Last Name:GANDHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS IN PHARMACY
Mailing Address - Street 1:608 21 ST AVE
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07513
Mailing Address - Country:US
Mailing Address - Phone:973-279-2200
Mailing Address - Fax:973-279-4933
Practice Address - Street 1:608 21 ST AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07513
Practice Address - Country:US
Practice Address - Phone:973-279-2200
Practice Address - Fax:973-279-4933
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02529500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist