1477161826 NPI number — DR. AMMIE J PATEL PHARMD, BCACP

Table of content: DR. AMMIE J PATEL PHARMD, BCACP (NPI 1477161826)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477161826 NPI number — DR. AMMIE J PATEL PHARMD, BCACP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATEL
Provider First Name:
AMMIE
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD, BCACP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477161826
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
222 PEASE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANALAPAN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07726-2642
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-986-1911
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
222 COLUMBIA TPKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLORHAM PARK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07932-1299
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-261-9077
Provider Business Practice Location Address Fax Number:
973-593-2060
Provider Enumeration Date:
07/21/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P2201X , with the licence number:  28RI03807700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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