Provider Demographics
NPI:1396060737
Name:PATEL, MOTILAL D (RPH)
Entity type:Individual
Prefix:
First Name:MOTILAL
Middle Name:D
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 1:328 SALVIA ST
Mailing Address - Street 2:
Mailing Address - City:BROWNS MILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:08015-1351
Mailing Address - Country:US
Mailing Address - Phone:609-735-7859
Mailing Address - Fax:
Practice Address - Street 1:328 SALVIA ST
Practice Address - Street 2:
Practice Address - City:BROWNS MILLS
Practice Address - State:NJ
Practice Address - Zip Code:08015-1351
Practice Address - Country:US
Practice Address - Phone:609-735-7859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038786-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
038786-1OtherPHARMIST REGISTRATION NUMBER