Provider Demographics
NPI:1992386908
Name:PATEL, HIRAL
Entity type:Individual
Prefix:
First Name:HIRAL
Middle Name:
Last Name:PATEL
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 1:1659 ROUTE 88 W STE C
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3011
Mailing Address - Country:US
Mailing Address - Phone:848-241-3129
Mailing Address - Fax:
Practice Address - Street 1:1659 ROUTE 88 W STE C
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3011
Practice Address - Country:US
Practice Address - Phone:848-241-3129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02997700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI02997700OtherNJ REGISTERED PHARMACIST LICENSE