Provider Demographics
NPI:1407142060
Name:PATEL, ABHISHEK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ABHISHEK
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 GABRIELLA TER
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:NY
Mailing Address - Zip Code:10924-6440
Mailing Address - Country:US
Mailing Address - Phone:732-647-5729
Mailing Address - Fax:845-292-9083
Practice Address - Street 1:1987 STATE ROUTE 52 STE 3
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:NY
Practice Address - Zip Code:12754-8317
Practice Address - Country:US
Practice Address - Phone:845-292-8200
Practice Address - Fax:845-292-9083
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059108183500000X
PARP444949183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist