Provider Demographics
NPI:1386626778
Name:PATEL, SHAILESH R (RPHMS)
Entity Type:Individual
Prefix:MR
First Name:SHAILESH
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPHMS
Other - Prefix:MR
Other - First Name:SHAILESH
Other - Middle Name:R
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH MS
Mailing Address - Street 1:120 BRADLEY AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-2504
Mailing Address - Country:US
Mailing Address - Phone:914-693-9411
Mailing Address - Fax:
Practice Address - Street 1:120 BRADLEY AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-2504
Practice Address - Country:US
Practice Address - Phone:914-693-9411
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0289671183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist