MEDICARE: MS. JEENAL KAPADIA

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	28RI03163600	NJ

General Provider Information

NPI Number	:	1457632044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JEENAL KAPADIA

Provider Business Mailing Address
First Line	:	61 SYCAMORE CT
Second Line	:
City	:	BASKING RIDGE
State	:	NJ
Zip	:	07920-3111
Country	:	US
Telephone Number	:	848-391-4400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2148 MORRIS AVE
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-6006
Country	:	US
Telephone Number	:	908-687-4994
Fax Number	:

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

Provider Enumeration Date	:	09/09/2011
Last Update Date	:	09/09/2011

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