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General NPI Number Information
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NPI Number | 1275167561
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Entity Type | Individual
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Provider Name | SUJAL A SHAH PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/26/2020
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Last Update Date | 02/26/2020
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Provider Practice Location Address
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Address Line | 501 JAUNCEY AVE
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City | LYNDHURST
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State | NJ
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Zip | 07071-3338
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Country | US
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Telephone | 201-920-1847
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Fax |
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Provider Business Mailing Address
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Address Line | 501 JAUNCEY AVE
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City | LYNDHURST
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State | NJ
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Zip | 07071-3338
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Country | US
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Telephone |
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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 | 066489
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 3873500
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License Number State | NJ
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