Provider Demographics
NPI:1306093737
Name:PATEL, SHAILESH A (RPH)
Entity type:Individual
Prefix:
First Name:SHAILESH
Middle Name:A
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 1:7 SYLDEO DR
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4300
Mailing Address - Country:US
Mailing Address - Phone:973-585-6474
Mailing Address - Fax:718-860-6468
Practice Address - Street 1:1603 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-2914
Practice Address - Country:US
Practice Address - Phone:718-860-0600
Practice Address - Fax:718-860-6468
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047061183500000X
NJ28RI02588000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist