Provider Demographics
NPI:1740686427
Name:PAGHDAL, CHIRAG (PHARMD)
Entity type:Individual
Prefix:MR
First Name:CHIRAG
Middle Name:
Last Name:PAGHDAL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 BARBARA ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-4001
Mailing Address - Country:US
Mailing Address - Phone:973-464-4964
Mailing Address - Fax:
Practice Address - Street 1:67 BARBARA ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-4001
Practice Address - Country:US
Practice Address - Phone:973-464-4964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-07
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20 059178183500000X
NJ28RI03391700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist