Healthcare Provider Details

I. General information

NPI: 1447920632
Provider Name (Legal Business Name): RONAK PRAVINBHAI BALAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2021
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 SMITH ST
PERTH AMBOY NJ
08861-4312
US

IV. Provider business mailing address

164 SMITH ST
PERTH AMBOY NJ
08861-4312
US

V. Phone/Fax

Practice location:
  • Phone: 732-324-4200
  • Fax: 732-324-4201
Mailing address:
  • Phone: 732-324-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI04205200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: