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General NPI Number Information
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NPI Number | 1114245115
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Entity Type | Individual
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Provider Name | VINOD I PATEL R.PH
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Gender | Male
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Dates
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Enumeration Date | 05/14/2010
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Last Update Date | 05/14/2010
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Provider Practice Location Address
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Address Line | 2 S BLACK HORSE PIKE
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City | BLACKWOOD
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State | NJ
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Zip | 08012-2951
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Country | US
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Telephone | 856-374-4602
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Fax | 856-374-4693
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Provider Business Mailing Address
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Address Line | 7 SANTALINA DR
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-4130
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Country | US
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Telephone | 856-262-2298
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Fax | 856-374-4693
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI02574600
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License Number State | NJ
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