Provider Demographics
NPI:1649529355
Name:PATEL, BIJAL M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BIJAL
Middle Name:M
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08401-6804
Mailing Address - Country:US
Mailing Address - Phone:609-441-7190
Mailing Address - Fax:609-441-7196
Practice Address - Street 1:1801 ATLANTIC AVE
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:ATLANTIC CITY
Practice Address - State:NJ
Practice Address - Zip Code:08401-6804
Practice Address - Country:US
Practice Address - Phone:609-441-9190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03621200183500000X
IL051296160183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist