Provider Demographics
NPI:1396338307
Name:PATEL, JATIN K (PHARMACIST)
Entity type:Individual
Prefix:
First Name:JATIN
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 COACH N FOUR
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08801-3500
Mailing Address - Country:US
Mailing Address - Phone:973-896-5975
Mailing Address - Fax:
Practice Address - Street 1:433 W UNION AVE
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1220
Practice Address - Country:US
Practice Address - Phone:732-356-3113
Practice Address - Fax:732-356-6691
Is Sole Proprietor?:No
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01877900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist