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General NPI Number Information
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NPI Number | 1174469357
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Entity Type | Individual
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Provider Name | MIRA PATEL
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Gender | Female
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Dates
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Enumeration Date | 04/28/2026
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Last Update Date | 04/28/2026
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Provider Practice Location Address
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Address Line | 338 PALISADE AVE
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City | JERSEY CITY
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State | NJ
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Zip | 07307-1753
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Country | US
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Telephone | 201-222-9399
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Fax |
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Provider Business Mailing Address
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Address Line | 9 LILY RD
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City | EDISON
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State | NJ
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Zip | 08820-1448
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Country | US
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Telephone | 732-589-2936
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Fax |
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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 | 28RI04490700
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License Number State | NJ
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