Provider Demographics
NPI:1053589770
Name:PATEL, KIRANKANT A (RPH)
Entity type:Individual
Prefix:MR
First Name:KIRANKANT
Middle Name:A
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 ROUTE 206
Mailing Address - Street 2:
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-9548
Mailing Address - Country:US
Mailing Address - Phone:973-252-9370
Mailing Address - Fax:973-252-8528
Practice Address - Street 1:293 ROUTE 206
Practice Address - Street 2:
Practice Address - City:FLANDERS
Practice Address - State:NJ
Practice Address - Zip Code:07836-9548
Practice Address - Country:US
Practice Address - Phone:973-252-9370
Practice Address - Fax:973-252-8528
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02298100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI02298100OtherNJ STATE BOARD OF PHARMAC