Provider Demographics
NPI:1427380328
Name:PATEL, DIPTI K (RPH)
Entity Type:Individual
Prefix:
First Name:DIPTI
Middle Name:K
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 ROUTE 109
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-6213
Mailing Address - Country:US
Mailing Address - Phone:631-587-9455
Mailing Address - Fax:631-661-7704
Practice Address - Street 1:365 ROUTE 109
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-6213
Practice Address - Country:US
Practice Address - Phone:631-587-9455
Practice Address - Fax:631-661-7704
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046357183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist