Provider Demographics
NPI:1043532849
Name:PATEL, RAJIV (PHARMD)
Entity Type:Individual
Prefix:
First Name:RAJIV
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5539 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-5217
Mailing Address - Country:US
Mailing Address - Phone:718-884-2500
Mailing Address - Fax:718-884-7500
Practice Address - Street 1:5539 BROADWAY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-5217
Practice Address - Country:US
Practice Address - Phone:718-884-2500
Practice Address - Fax:718-884-7500
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-20
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047476183500000X
NJ028RI27183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist