MEDICARE: TEJASVI PATEL

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	28RI03127300	NJ

General Provider Information

NPI Number	:	1669785630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TEJASVI PATEL

Provider Business Mailing Address
First Line	:	100 GLENWOOD AVE
Second Line	:	APT D1
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-5944
Country	:	US
Telephone Number	:	732-418-1100
Fax Number	:	732-418-1109

Provider Business Practice Location Address
First Line	:	159 FRENCH ST
Second Line	:
City	:	NEW BRUNSWICK
State	:	NJ
Zip	:	08901-2341
Country	:	US
Telephone Number	:	732-418-1100
Fax Number	:	732-418-1109

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

Provider Enumeration Date	:	07/20/2010
Last Update Date	:	07/20/2010

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Directions to “ TEJASVI PATEL ” Practice Location

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