Provider Demographics
NPI:1033452511
Name:PATEL, NAVNIT R
Entity Type:Individual
Prefix:
First Name:NAVNIT
Middle Name:R
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 1:12813 NIGHT OWL CT
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:VA
Mailing Address - Zip Code:20136-5101
Mailing Address - Country:US
Mailing Address - Phone:703-335-6458
Mailing Address - Fax:
Practice Address - Street 1:12813 NIGHT OWL CT
Practice Address - Street 2:
Practice Address - City:BRISTOW
Practice Address - State:VA
Practice Address - Zip Code:20136-5101
Practice Address - Country:US
Practice Address - Phone:703-335-6458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202011112183500000X
FLPS29057183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist