Provider Demographics
NPI:1417181843
Name:PATEL, JIGNESH
Entity Type:Individual
Prefix:
First Name:JIGNESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1639 HAINES RD
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19055-1803
Mailing Address - Country:US
Mailing Address - Phone:215-547-0250
Mailing Address - Fax:215-547-0202
Practice Address - Street 1:1627 HAINES RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19055-1803
Practice Address - Country:US
Practice Address - Phone:215-547-0250
Practice Address - Fax:215-547-0202
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03131100183500000X
PARP440547183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist