Provider Demographics
NPI:1821548942
Name:PATEL, MITESH RAJENDRA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MITESH
Middle Name:RAJENDRA
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 1:515 IRON BRIDGE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-5300
Mailing Address - Country:US
Mailing Address - Phone:732-252-6455
Mailing Address - Fax:
Practice Address - Street 1:515 IRON BRIDGE RD STE 1
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-5300
Practice Address - Country:US
Practice Address - Phone:732-252-6455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-13
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03662600183500000X
PARP450019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist