MEDICARE: HARSHAV RAVAL PHARMD

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	28RI03858000	NJ

General Provider Information

NPI Number	:	1497477020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARSHAV RAVAL PHARMD

Provider Business Mailing Address
First Line	:	1412 TAVERN RD
Second Line	:
City	:	MONROE TOWNSHIP
State	:	NJ
Zip	:	08831-7307
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 HICKORY CORNER RD STE 106
Second Line	:
City	:	EAST WINDSOR
State	:	NJ
Zip	:	08520-2460
Country	:	US
Telephone Number	:	609-308-2887
Fax Number	:

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

Provider Enumeration Date	:	09/12/2022
Last Update Date	:	09/12/2022

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