Healthcare Provider Details

I. General information

NPI: 1417797127
Provider Name (Legal Business Name): SAPNA PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

981 W SIDE AVE
JERSEY CITY NJ
07306-6903
US

IV. Provider business mailing address

28 SKILLMAN AVE
JERSEY CITY NJ
07306-5110
US

V. Phone/Fax

Practice location:
  • Phone: 201-332-0410
  • Fax:
Mailing address:
  • Phone: 201-334-2488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04370800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: