Provider Demographics
NPI:1083441729
Name:BAMBHROLIA, ANUJ RAMESH
Entity type:Individual
Prefix:
First Name:ANUJ
Middle Name:RAMESH
Last Name:BAMBHROLIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 CRAWFORD ST
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2911
Mailing Address - Country:US
Mailing Address - Phone:732-857-4981
Mailing Address - Fax:
Practice Address - Street 1:1001 NJ-70
Practice Address - Street 2:
Practice Address - City:MANCHESTER TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08759
Practice Address - Country:US
Practice Address - Phone:732-657-0099
Practice Address - Fax:732-657-0033
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04334800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist