Provider Demographics
NPI:1578856787
Name:PATEL, VINUBHAI D (RPH)
Entity Type:Individual
Prefix:MR
First Name:VINUBHAI
Middle Name:D
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 1:249 GRAHAM AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-1201
Mailing Address - Country:US
Mailing Address - Phone:718-384-6630
Mailing Address - Fax:718-384-3331
Practice Address - Street 1:249 GRAHAM AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-1201
Practice Address - Country:US
Practice Address - Phone:718-384-6630
Practice Address - Fax:718-384-3331
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-20
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043626-1183500000X
NY00894248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist