Pankti Shah
Individual provider Active NPI Pharmacist · Port Monmouth, NJ
NPI 1356791016 · NPPES record last updated Jun 14, 2016
Key facts
- NPI
- 1356791016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 28RI03733900 (NJ)
- Practice address
- 200 Wilson Ave
Port Monmouth, NJ 07758-1228 - Phone
- (732) 495-0156
- NPI assigned
- Jun 14, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI03733900 | NJ | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI03733900 | NJ | Yes |
Addresses
Primary practice location
200 Wilson Ave
Port Monmouth, NJ 07758-1228
Mailing address
200 Wilson Ave
Port Monmouth, NJ 07758-1228
Phone (732) 495-0156
Other providers in Port Monmouth, NJ
- Ogugua Osefoh
- James Park
- Danyelle Rolnick
- Brooke Ashlie Rudolph
- Victoria Russo
- Manu Sharma
- Kristina Tahirova
- Lauren Tenenbaum
- Yelena Tulman
- Walgreen Co
All providers in Port Monmouth, NJ · Pharmacist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.