Provider Demographics
NPI:1043434285
Name:PATEL, SEJAL MAHESH
Entity Type:Individual
Prefix:
First Name:SEJAL
Middle Name:MAHESH
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2694 AFRICAN VIOLET AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-1959
Mailing Address - Country:US
Mailing Address - Phone:702-897-5399
Mailing Address - Fax:
Practice Address - Street 1:2694 AFRICAN VIOLET AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-1959
Practice Address - Country:US
Practice Address - Phone:702-897-5399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11496183500000X
CA46081183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist