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NPI Code Detail

MEDICARE: PRIYANKA THAKER

MEDICARE: PRIYANKA THAKER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist28RI04051700NJ

General Provider Information

NPI Number : 1750992491
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRIYANKA THAKER
Provider Business Mailing Address
First Line : 1561 JOHN F KENNEDY BLVD
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07305-1721
Country : US
Telephone Number : 201-332-4668
Fax Number :
Provider Business Practice Location Address
First Line : 1561 JOHN F KENNEDY BLVD
Second Line :
City : JERSEY CITY
State : NJ
Zip : 07305-1721
Country : US
Telephone Number : 201-332-4668
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2020
Last Update Date : 08/16/2020

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Directions to “ PRIYANKA THAKER ” Practice Location

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