Provider Demographics
NPI:1154580488
Name:PATEL, RAJENDRAKUMAR CHATURBHAI (RPH)
Entity type:Individual
Prefix:
First Name:RAJENDRAKUMAR
Middle Name:CHATURBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 W 125TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-4831
Mailing Address - Country:US
Mailing Address - Phone:212-222-1300
Mailing Address - Fax:212-222-1308
Practice Address - Street 1:379 W 125TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4831
Practice Address - Country:US
Practice Address - Phone:212-222-1300
Practice Address - Fax:212-222-1308
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046712183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist