Provider Demographics
NPI:1689921819
Name:PATEL, PRAGNYA J (PHARMD)
Entity Type:Individual
Prefix:
First Name:PRAGNYA
Middle Name:J
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22251 ABINGTON DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-4309
Mailing Address - Country:US
Mailing Address - Phone:269-352-3577
Mailing Address - Fax:
Practice Address - Street 1:4000 HIGHLAND RD
Practice Address - Street 2:SUITE 113
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-2167
Practice Address - Country:US
Practice Address - Phone:248-977-1394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033906183500000X, 1835N1003X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist