Provider Demographics
NPI:1902654171
Name:SHETH, SUNNY T (PHARMD, MBA, RPH)
Entity Type:Individual
Prefix:DR
First Name:SUNNY
Middle Name:T
Last Name:SHETH
Suffix:
Gender:M
Credentials:PHARMD, MBA, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BROWN CT
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1520
Mailing Address - Country:US
Mailing Address - Phone:973-796-7388
Mailing Address - Fax:
Practice Address - Street 1:195 1ST AVE W
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07107-2618
Practice Address - Country:US
Practice Address - Phone:973-482-8220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04335400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist