Healthcare Provider Details

I. General information

NPI: 1477528347
Provider Name (Legal Business Name): RASIK L PATEL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

976 VALLEY RD
WATCHUNG NJ
07069-6145
US

IV. Provider business mailing address

976 VALLEY RD
WATCHUNG NJ
07069-6145
US

V. Phone/Fax

Practice location:
  • Phone: 201-233-3004
  • Fax:
Mailing address:
  • Phone: 201-233-3004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02955700
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051439
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: