Provider Demographics
NPI:1801125885
Name:PATEL, KUNJESH A (PHARMD)
Entity type:Individual
Prefix:
First Name:KUNJESH
Middle Name:A
Last Name:PATEL
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 1:2508 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-1134
Mailing Address - Country:US
Mailing Address - Phone:201-240-3456
Mailing Address - Fax:201-955-0345
Practice Address - Street 1:150 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-5950
Practice Address - Country:US
Practice Address - Phone:201-955-0162
Practice Address - Fax:201-955-0345
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-21
Last Update Date:2015-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053869183500000X
CTPCT.0011480183500000X
NJ28RI03343400183500000X
PARP449307183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist