Provider Demographics
NPI:1174811228
Name:PATEL, VITHAL K (R PH)
Entity type:Individual
Prefix:MR
First Name:VITHAL
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 EQUESTRIAN WAY
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-4085
Mailing Address - Country:US
Mailing Address - Phone:732-656-7608
Mailing Address - Fax:
Practice Address - Street 1:40 EQUESTRIAN WAY
Practice Address - Street 2:
Practice Address - City:MONROE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08831-4085
Practice Address - Country:US
Practice Address - Phone:732-656-7608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist