=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629765185
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HITESH PATEL PHARMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/24/2023
-----------------------------------------------------
Last Update Date | 04/24/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 SOUTHARD ST
-----------------------------------------------------
City | TRENTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08609-1020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-341-1990
-----------------------------------------------------
Fax | 609-341-1991
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 680 BOUND BROOK RD
-----------------------------------------------------
City | MIDDLESEX
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08846-2109
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-593-7020
-----------------------------------------------------
Fax | 908-755-1713
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 28RI03563400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------