Provider Demographics
NPI:1952552952
Name:DALAL, GIRISH K (RPH)
Entity Type:Individual
Prefix:
First Name:GIRISH
Middle Name:K
Last Name:DALAL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-4324
Mailing Address - Country:US
Mailing Address - Phone:732-324-4200
Mailing Address - Fax:732-324-4201
Practice Address - Street 1:238 SMITH ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4324
Practice Address - Country:US
Practice Address - Phone:732-324-4200
Practice Address - Fax:732-324-4201
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01953000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI01953000OtherPHARMACIST LICENSE