Provider Demographics
NPI:1104132653
Name:PATEL, MAITRIBEN RUCHIR (RPH)
Entity type:Individual
Prefix:MRS
First Name:MAITRIBEN
Middle Name:RUCHIR
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 FENTON LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08515-9724
Mailing Address - Country:US
Mailing Address - Phone:609-372-4918
Mailing Address - Fax:
Practice Address - Street 1:1700 N OLDEN AVE
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08638-3102
Practice Address - Country:US
Practice Address - Phone:609-896-9089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-22
Last Update Date:2010-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03044800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist