Provider Demographics
NPI:1790406437
Name:PATEL, ARATIBEN
Entity Type:Individual
Prefix:
First Name:ARATIBEN
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 MARY ANNE KEYS LN
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-3098
Mailing Address - Country:US
Mailing Address - Phone:845-542-0528
Mailing Address - Fax:
Practice Address - Street 1:2408 SUSANNAH ST STE 3
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-1765
Practice Address - Country:US
Practice Address - Phone:423-202-7870
Practice Address - Fax:423-264-2502
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45129183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist