Provider Demographics
NPI:1114378932
Name:PATEL, CHANDNI P (RPH)
Entity type:Individual
Prefix:
First Name:CHANDNI
Middle Name:P
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-6244
Mailing Address - Country:US
Mailing Address - Phone:230-433-3395
Mailing Address - Fax:
Practice Address - Street 1:110 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6244
Practice Address - Country:US
Practice Address - Phone:203-433-3395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-22
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA74450183500000X
CT0013447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist