Provider Demographics
NPI:1609398783
Name:SHAH, HIRAL
Entity type:Individual
Prefix:
First Name:HIRAL
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:499 ERNSTON RD
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-1406
Mailing Address - Country:US
Mailing Address - Phone:1732-952-3022
Mailing Address - Fax:
Practice Address - Street 1:499 ERNSTON RD
Practice Address - Street 2:
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-1406
Practice Address - Country:US
Practice Address - Phone:732-952-3022
Practice Address - Fax:732-952-3022
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03287200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist