Provider Demographics
NPI:1578796058
Name:PATEL, JAY C (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:C
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 1:25 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06424-1087
Mailing Address - Country:US
Mailing Address - Phone:860-267-0732
Mailing Address - Fax:860-267-8709
Practice Address - Street 1:25 E HIGH ST
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:CT
Practice Address - Zip Code:06424-1087
Practice Address - Country:US
Practice Address - Phone:860-267-0732
Practice Address - Fax:860-267-8709
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.10134183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist