Provider Demographics
NPI:1073768503
Name:PATEL, AMAR B (RPH)
Entity Type:Individual
Prefix:
First Name:AMAR
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1208 ROUTE 300
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-5003
Mailing Address - Country:US
Mailing Address - Phone:845-275-0816
Mailing Address - Fax:845-275-0846
Practice Address - Street 1:1208 ROUTE 300
Practice Address - Street 2:SUITE 103
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5003
Practice Address - Country:US
Practice Address - Phone:845-275-0816
Practice Address - Fax:845-275-0846
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY053122183500000X
MA24605183500000X
CT11181183500000X
NJ28RI03263200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist