Healthcare Provider Details

I. General information

NPI: 1649529355
Provider Name (Legal Business Name): BIJAL M PATEL PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2012
Last Update Date: 10/04/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11290 W BROAD ST
GLEN ALLEN VA
23060-5815
US

IV. Provider business mailing address

1801 ATLANTIC AVE
ATLANTIC CITY NJ
08401-6804
US

V. Phone/Fax

Practice location:
  • Phone: 804-360-8912
  • Fax:
Mailing address:
  • Phone: 609-441-7190
  • Fax: 609-441-7196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051296160
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202215799
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03621200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: