Healthcare Provider Details

I. General information

NPI: 1639092141
Provider Name (Legal Business Name): BIREN PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 ROUTE 73 N
MAPLE SHADE NJ
08052-2058
US

IV. Provider business mailing address

2920 ROUTE 73 N
MAPLE SHADE NJ
08052-2058
US

V. Phone/Fax

Practice location:
  • Phone: 856-667-2811
  • Fax:
Mailing address:
  • Phone: 856-667-2811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number28RW04582800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: