Provider Demographics
NPI:1083946115
Name:PATEL, DHIREN BHARATKUMAR (MS, RPH)
Entity Type:Individual
Prefix:MR
First Name:DHIREN
Middle Name:BHARATKUMAR
Last Name:PATEL
Suffix:
Gender:M
Credentials:MS, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3293 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-7909
Mailing Address - Country:US
Mailing Address - Phone:212-281-0488
Mailing Address - Fax:212-281-0487
Practice Address - Street 1:3771 103RD ST
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-3191
Practice Address - Country:US
Practice Address - Phone:718-779-4450
Practice Address - Fax:718-779-4453
Is Sole Proprietor?:No
Enumeration Date:2010-01-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02788500183500000X
NY047288183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY047288OtherNEW YORK STATE BOARD OF PHARMACY
NJ28RI02788500OtherNEW JERSEY BOARD OF PHARMACY