Provider Demographics
NPI:1376586586
Name:PATEL, POPATLAL A (R PH)
Entity Type:Individual
Prefix:MR
First Name:POPATLAL
Middle Name:A
Last Name:PATEL
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-2124
Mailing Address - Country:US
Mailing Address - Phone:914-813-2674
Mailing Address - Fax:914-235-1120
Practice Address - Street 1:301 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-2124
Practice Address - Country:US
Practice Address - Phone:914-813-2674
Practice Address - Fax:914-235-1120
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029629-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY029629-1OtherPHARMACIST
NJ28RI01557200OtherPHARMACIST NEW JERSEY