MEDICARE: RONAK PRAVINBHAI BALAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RI04205200	NJ

General Provider Information

NPI Number	:	1447920632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONAK PRAVINBHAI BALAR

Provider Business Mailing Address
First Line	:	430 MADISON AVE
Second Line	:
City	:	PATERSON
State	:	NJ
Zip	:	07524-2728
Country	:	US
Telephone Number	:	973-278-5808
Fax Number	:

Provider Business Practice Location Address
First Line	:	430 MADISON AVE
Second Line	:
City	:	PATERSON
State	:	NJ
Zip	:	07524-2728
Country	:	US
Telephone Number	:	973-278-5808
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2021
Last Update Date	:	09/17/2021

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Directions to “ RONAK PRAVINBHAI BALAR ” Practice Location

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