Provider Demographics
NPI:1538673884
Name:PATEL, AMISHA (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMISHA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5127 CADAGAN CT
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2328
Mailing Address - Country:US
Mailing Address - Phone:215-359-6670
Mailing Address - Fax:
Practice Address - Street 1:1336 BRISTOL PIKE STE 100
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-5670
Practice Address - Country:US
Practice Address - Phone:215-638-8190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-23
Last Update Date:2017-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03889300183500000X
PARP451822183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist