Provider Demographics
NPI:1023334703
Name:PATEL, VIKRAM R (RPH)
Entity type:Individual
Prefix:MR
First Name:VIKRAM
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 N OLDEN AVE
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08638-3100
Mailing Address - Country:US
Mailing Address - Phone:609-219-0076
Mailing Address - Fax:609-219-0655
Practice Address - Street 1:1750 N OLDEN AVE
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08638-3100
Practice Address - Country:US
Practice Address - Phone:609-219-0076
Practice Address - Fax:609-219-0655
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02125200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist