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General NPI Number Information
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NPI Number | 1851669154
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Entity Type | Individual
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Provider Name | MR. DINESH GANATRA
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Gender | Male
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Dates
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Enumeration Date | 12/01/2011
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Last Update Date | 12/01/2011
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Provider Practice Location Address
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Address Line | 124 SPRUCE ST
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City | NEWARK
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State | NJ
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Zip | 07108-3015
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Country | US
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Telephone | 973-623-1876
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Fax | 973-623-2260
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Provider Business Mailing Address
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Address Line | 23 BALTIC ST
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City | EDISON
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State | NJ
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Zip | 08820-2726
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Country | US
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Telephone | 732-516-1767
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Fax | 973-623-2260
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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 | 28RS00293500
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License Number State | NJ
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