Healthcare Provider Details

I. General information

NPI: 1578723995
Provider Name (Legal Business Name): AMIT JASHU PATEL PHARM. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 NEWFIELD AVE
EDISON NJ
08837-3824
US

IV. Provider business mailing address

5 STACEY ST
EDISON NJ
08820-1832
US

V. Phone/Fax

Practice location:
  • Phone: 732-346-1333
  • Fax:
Mailing address:
  • Phone: 908-753-6362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03207700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: