=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821743733
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YOGESH H CHANDRANI PHARMACIST
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/18/2022
-----------------------------------------------------
Last Update Date | 02/18/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1149 STATE ROUTE 35
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07748-2699
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-671-0350
-----------------------------------------------------
Fax | 732-671-3725
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1149 STATE ROUTE 35
-----------------------------------------------------
City | MIDDLETOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07748-2699
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-671-0350
-----------------------------------------------------
Fax | 732-671-3725
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 28RI03280200
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------