Provider Demographics
NPI:1821755778
Name:PATEL, BHUNESHWARI INDRAVADAN (RPH)
Entity Type:Individual
Prefix:
First Name:BHUNESHWARI
Middle Name:INDRAVADAN
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 1:725 LYSLE BLVD # PA15132
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-2515
Mailing Address - Country:US
Mailing Address - Phone:412-672-3853
Mailing Address - Fax:
Practice Address - Street 1:725 LYSLE BLVD
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-2515
Practice Address - Country:US
Practice Address - Phone:412-672-3853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP455714183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARPI015240OtherIMMUNIZATION PHARMACIST
PARP455714OtherREGISTERED LICENSED PHARMACIST