Provider Demographics
NPI:1558684167
Name:PATEL, ANANTBHAI J
Entity Type:Individual
Prefix:MR
First Name:ANANTBHAI
Middle Name:J
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 1:4480 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-2606
Mailing Address - Country:US
Mailing Address - Phone:212-567-3384
Mailing Address - Fax:212-567-9643
Practice Address - Street 1:4480 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-2606
Practice Address - Country:US
Practice Address - Phone:212-567-3384
Practice Address - Fax:212-567-9643
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047872183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist