Provider Demographics
NPI:1962112037
Name:KARCHAL, ANIRUD PATIL
Entity type:Individual
Prefix:
First Name:ANIRUD PATIL
Middle Name:
Last Name:KARCHAL
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 1:362 SIP AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-6574
Mailing Address - Country:US
Mailing Address - Phone:201-920-7392
Mailing Address - Fax:
Practice Address - Street 1:362 SIP AVE APT 3
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-6574
Practice Address - Country:US
Practice Address - Phone:201-920-7392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04285700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJK05510450005912OtherDRIVING LICENSE