Provider Demographics
NPI:1467623801
Name:PATEL, MUKESH J (RPH)
Entity Type:Individual
Prefix:
First Name:MUKESH
Middle Name:J
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 1:1310 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-3905
Mailing Address - Country:US
Mailing Address - Phone:914-833-3001
Mailing Address - Fax:914-833-9627
Practice Address - Street 1:1310 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-3905
Practice Address - Country:US
Practice Address - Phone:914-833-3001
Practice Address - Fax:914-833-9627
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044351-1183500000X
CT8076183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist