MEDICARE: MR. NILESH PATEL RPH

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	28RI02587700	NJ

General Provider Information

NPI Number	:	1467872440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NILESH PATEL RPH

Provider Business Mailing Address
First Line	:	305 BROADWAY
Second Line	:
City	:	PATERSON
State	:	NJ
Zip	:	07501-2102
Country	:	US
Telephone Number	:	973-523-0777
Fax Number	:	973-279-0489

Provider Business Practice Location Address
First Line	:	305 BROADWAY
Second Line	:
City	:	PATERSON
State	:	NJ
Zip	:	07501-2102
Country	:	US
Telephone Number	:	973-523-0777
Fax Number	:	973-279-0489

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

Provider Enumeration Date	:	04/17/2014
Last Update Date	:	04/17/2014

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