Provider Demographics
NPI:1871862714
Name:PATEL, JYUTHIKA ROHAN (RPH)
Entity Type:Individual
Prefix:
First Name:JYUTHIKA
Middle Name:ROHAN
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 1:2323 MEADOWPOINT DR APT C
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-2474
Mailing Address - Country:US
Mailing Address - Phone:260-414-4356
Mailing Address - Fax:
Practice Address - Street 1:20 W MARKET ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-3993
Practice Address - Country:US
Practice Address - Phone:937-339-8341
Practice Address - Fax:937-339-9927
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03127665183500000X
IN26020100A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist