Provider Demographics
NPI:1902155849
Name:PATEL, MANAN
Entity type:Individual
Prefix:MR
First Name:MANAN
Middle Name:
Last Name:PATEL
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 1:1068 ESSEX DR
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-4263
Mailing Address - Country:US
Mailing Address - Phone:215-908-1198
Mailing Address - Fax:
Practice Address - Street 1:575 HORSHAM RD UNIT C20
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-0137
Practice Address - Country:US
Practice Address - Phone:215-674-5050
Practice Address - Fax:215-957-5874
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0004307183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist