Provider Demographics
NPI:1144477811
Name:PAGHDAL, VIPUL GORDHAN (PHARMD)
Entity type:Individual
Prefix:MR
First Name:VIPUL
Middle Name:GORDHAN
Last Name:PAGHDAL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:392B BEDFORD PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-2415
Mailing Address - Country:US
Mailing Address - Phone:718-933-1154
Mailing Address - Fax:718-365-0202
Practice Address - Street 1:392B BEDFORD PARK BLVD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-2415
Practice Address - Country:US
Practice Address - Phone:718-933-1154
Practice Address - Fax:718-365-0202
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048364183500000X
NJ28RI02695800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist