Provider Demographics
NPI:1699068882
Name:PATEL, SUNITABEN H (PHARMACIST)
Entity type:Individual
Prefix:
First Name:SUNITABEN
Middle Name:H
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:SUNITA
Other - Middle Name:H
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:177 LONE TREE DR
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:DE
Mailing Address - Zip Code:19934-4734
Mailing Address - Country:US
Mailing Address - Phone:551-689-3026
Mailing Address - Fax:
Practice Address - Street 1:916 MAIN AVE
Practice Address - Street 2:1 B
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-8545
Practice Address - Country:US
Practice Address - Phone:973-470-5668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03411400183500000X
DEA1-0004008183500000X
MI5302037885183500000X
CTPCT.0011540183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist