Healthcare Provider Details

I. General information

NPI: 1508778192
Provider Name (Legal Business Name): VIPUL PATEL
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 COTTAGE GROVE RD
BLOOMFIELD CT
06002-2920
US

IV. Provider business mailing address

725 NUGENT ST
PARAMUS NJ
07652-2250
US

V. Phone/Fax

Practice location:
  • Phone: 201-406-9123
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03262700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: