Provider Demographics
NPI:1750981262
Name:PATEL, ASHISH
Entity type:Individual
Prefix:
First Name:ASHISH
Middle Name:
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 1:105 ADAMS WAY
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-3440
Mailing Address - Country:US
Mailing Address - Phone:732-833-1564
Mailing Address - Fax:
Practice Address - Street 1:700 MARKETPLACE BLVD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08691-2115
Practice Address - Country:US
Practice Address - Phone:609-585-1329
Practice Address - Fax:609-585-1374
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02491300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist