Healthcare Provider Details

I. General information

NPI: 1487921680
Provider Name (Legal Business Name): NIRAL PATEL PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2011
Last Update Date: 08/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 ALBEMARLE RD
CHARLOTTE NC
28212-3814
US

IV. Provider business mailing address

1147 COOPER ST
EDGEWATER PARK NJ
08010-2558
US

V. Phone/Fax

Practice location:
  • Phone: 704-568-2950
  • Fax: 704-563-0194
Mailing address:
  • Phone: 609-877-0013
  • Fax: 609-877-4902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21476
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03129800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: