Provider Demographics
NPI:1225246333
Name:PATEL, BHAVANA H (MPHARM, PHARM D)
Entity Type:Individual
Prefix:DR
First Name:BHAVANA
Middle Name:H
Last Name:PATEL
Suffix:
Gender:F
Credentials:MPHARM, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-5558
Mailing Address - Country:US
Mailing Address - Phone:609-646-8010
Mailing Address - Fax:609-965-1953
Practice Address - Street 1:4238 HARBOR BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BRIGANTINE
Practice Address - State:NJ
Practice Address - Zip Code:08203-1361
Practice Address - Country:US
Practice Address - Phone:609-266-8999
Practice Address - Fax:609-266-2430
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03001200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist