Provider Demographics
NPI:1588946040
Name:MISTRY, PINAL VISHAL (PHARM D)
Entity type:Individual
Prefix:DR
First Name:PINAL
Middle Name:VISHAL
Last Name:MISTRY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 INMAN AVE
Mailing Address - Street 2:
Mailing Address - City:COLONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07067-1114
Mailing Address - Country:US
Mailing Address - Phone:732-396-8701
Mailing Address - Fax:732-396-1341
Practice Address - Street 1:3430 OHIO HEALTH PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43202-1575
Practice Address - Country:US
Practice Address - Phone:614-566-2170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2020-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RIO3173200183500000X
OH03438428183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist