Provider Demographics
NPI:1356467005
Name:PATEL, ATULKUMAR KANTIBHAI (RPH)
Entity Type:Individual
Prefix:
First Name:ATULKUMAR
Middle Name:KANTIBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11101 66TH AVE APT 3B
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1912
Mailing Address - Country:US
Mailing Address - Phone:718-275-3298
Mailing Address - Fax:
Practice Address - Street 1:17 WEST 125 ST
Practice Address - Street 2:HARLEM PHARMACY
Practice Address - City:MANHATTAN
Practice Address - State:NY
Practice Address - Zip Code:10027
Practice Address - Country:US
Practice Address - Phone:212-831-0200
Practice Address - Fax:212-831-0230
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047524183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist