=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124729702
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | POOJA M VEKARIA PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2023
-----------------------------------------------------
Last Update Date | 03/13/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 236 HARRISON AVE
-----------------------------------------------------
City | HARRISON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07029-1347
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-900-9275
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 175 GLANZ AVE
-----------------------------------------------------
City | NORTHVALE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07647-1838
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 201-560-8077
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 28RI04277600
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------