Provider Demographics
NPI:1568619625
Name:PATEL, DHIREN K (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DHIREN
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S HUNTINGTON AVE # 119
Mailing Address - Street 2:FLOOR 10D
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4817
Mailing Address - Country:US
Mailing Address - Phone:857-364-4310
Mailing Address - Fax:857-364-4506
Practice Address - Street 1:150 S HUNTINGTON AVE # 119
Practice Address - Street 2:FLOOR 10D
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130-4817
Practice Address - Country:US
Practice Address - Phone:857-364-4310
Practice Address - Fax:857-364-4506
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA27564183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist