Healthcare Provider Details

I. General information

NPI: 1255616827
Provider Name (Legal Business Name): MINESH HASMUKH PATEL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2011
Last Update Date: 10/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 MARTIN LUTHER KING # JR
EAST ORANGE NJ
07018-2207
US

IV. Provider business mailing address

834 NELSON PL
PISCATAWAY NJ
08854-3224
US

V. Phone/Fax

Practice location:
  • Phone: 973-672-6317
  • Fax: 973-672-6129
Mailing address:
  • Phone: 732-424-0818
  • Fax: 732-424-0818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03227800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: