Healthcare Provider Details

I. General information

NPI: 1740291095
Provider Name (Legal Business Name): SEJAL MEDIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 UNION AVE
CRESSKILL NJ
07626
US

IV. Provider business mailing address

48 UNION AVE
CRESSKILL NJ
07626
US

V. Phone/Fax

Practice location:
  • Phone: 201-567-2235
  • Fax: 201-567-1881
Mailing address:
  • Phone: 201-567-2235
  • Fax: 201-567-1881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number280500631500
License Number StateNJ

VIII. Authorized Official

Name: SHREYAS S SHAH
Title or Position: RPH IN CHARGE PRESIDENT
Credential: RPH
Phone: 201-567-1881