Provider Demographics
NPI:1366620619
Name:GOHIL, MAHENDRA UTTAMRAM
Entity type:Individual
Prefix:MR
First Name:MAHENDRA
Middle Name:UTTAMRAM
Last Name:GOHIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 WENLOCK RD
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-3072
Mailing Address - Country:US
Mailing Address - Phone:585-223-6541
Mailing Address - Fax:585-671-6383
Practice Address - Street 1:1900 EMPIRE BLVD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-1934
Practice Address - Country:US
Practice Address - Phone:585-671-5665
Practice Address - Fax:585-671-6383
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist