Provider Demographics
NPI:1386155836
Name:SHAH, NISHIT H (PHARM D)
Entity type:Individual
Prefix:
First Name:NISHIT
Middle Name:H
Last Name:SHAH
Suffix:
Gender:M
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 1:22 GODWIN PL
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3708
Mailing Address - Country:US
Mailing Address - Phone:973-928-9268
Mailing Address - Fax:
Practice Address - Street 1:1700 OAK TREE RD STE 1
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2854
Practice Address - Country:US
Practice Address - Phone:732-662-9292
Practice Address - Fax:732-662-9295
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03874500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist