Provider Demographics
NPI:1609181684
Name:PATEL, KUNJAL KIRAN (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KUNJAL
Middle Name:KIRAN
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 LYNN WAY
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-8535
Mailing Address - Country:US
Mailing Address - Phone:215-990-4540
Mailing Address - Fax:
Practice Address - Street 1:640 LYNN WAY
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-8535
Practice Address - Country:US
Practice Address - Phone:215-990-4540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH032249322183500000X
IL051288599183500000X
NJ28RI02950400183500000X
PARP045311L183500000X
MD19600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ28RI02950400OtherPHARMACY LICENSE
OH032249322OtherPHARMACY LICENSE
IL051288599OtherPHARMACY LICENSE
PARP045311LOtherPHARMACY LICENSE
MD19600OtherPHARMACY LICENSE