Provider Demographics
NPI:1619156643
Name:PATEL, SEJAL N (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SEJAL
Middle Name:N
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 VICTORIAN LANE
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11545
Mailing Address - Country:US
Mailing Address - Phone:516-780-1776
Mailing Address - Fax:
Practice Address - Street 1:901 ROUTE 110
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3906
Practice Address - Country:US
Practice Address - Phone:631-752-8980
Practice Address - Fax:631-694-3479
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI044263-1183500000X
NY044263183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist