Provider Demographics
NPI:1871199919
Name:PATEL, NIRALI GHANSHYAM (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:NIRALI
Middle Name:GHANSHYAM
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 1:2116 HEMMINGWAY DR
Mailing Address - Street 2:
Mailing Address - City:NESBIT
Mailing Address - State:MS
Mailing Address - Zip Code:38651-9405
Mailing Address - Country:US
Mailing Address - Phone:603-818-1907
Mailing Address - Fax:
Practice Address - Street 1:5219 HIGHWAY 51 N
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-1719
Practice Address - Country:US
Practice Address - Phone:662-562-8266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA27020183500000X
AR14382183500000X
NH3505183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist