Healthcare Provider Details

I. General information

NPI: 1295048437
Provider Name (Legal Business Name): KAKUBHAI R VORA PH.D., R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 07/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 MOUNTAIN AVE
HACKETTSTOWN NJ
07840
US

IV. Provider business mailing address

924 PENNSYLVANIA AVENUE
WESTFIELD NJ
07090-3433
US

V. Phone/Fax

Practice location:
  • Phone: 908-852-2223
  • Fax:
Mailing address:
  • Phone: 908-654-9577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI01400100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: