Provider Demographics
NPI:1285956623
Name:PATEL, BHAKTI DHARMESH (RPH)
Entity type:Individual
Prefix:
First Name:BHAKTI
Middle Name:DHARMESH
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 1:753 JAMES ST UNIT C4
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-2108
Mailing Address - Country:US
Mailing Address - Phone:315-399-4677
Mailing Address - Fax:315-399-4678
Practice Address - Street 1:753 JAMES ST UNIT C4
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-2108
Practice Address - Country:US
Practice Address - Phone:315-399-4677
Practice Address - Fax:315-399-4678
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053437183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist