=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366252033
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VIDHI THAKAR
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2025
-----------------------------------------------------
Last Update Date | 01/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 410 ROUTE 10
-----------------------------------------------------
City | WHIPPANY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07981-1512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-884-4960
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19 TEMPLAR WAY
-----------------------------------------------------
City | PARSIPPANY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07054-4036
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-925-1671
-----------------------------------------------------
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 | 28RI04288700
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------