Individual
KETANKUMAR PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1905 ROUTE 88 STE 5, BRICK, NJ 08724-3156
(732) 861-6577
Mailing address
339 TEXAS RD, MORGANVILLE, NJ 07751-4105
(732) 861-6577
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03918300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28RI03918300
REGISTERED PHARMACIST LICENSE
NJ
Enumeration date
04/21/2021
Last updated
04/21/2021
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