Provider Demographics
NPI:1396034641
Name:PATEL, YOGESHKUMAR B (RPH)
Entity Type:Individual
Prefix:
First Name:YOGESHKUMAR
Middle Name:B
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 1:6 OLDE ORCHARD PARK APT 617
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6968
Mailing Address - Country:US
Mailing Address - Phone:810-730-7056
Mailing Address - Fax:802-864-6080
Practice Address - Street 1:75 PEARL ST
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-3625
Practice Address - Country:US
Practice Address - Phone:802-878-3369
Practice Address - Fax:802-878-7595
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0330003677183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist