Provider Demographics
NPI:1891085460
Name:PATEL, DEWAL H (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DEWAL
Middle Name:H
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 1:320 BEVERLY RANCOCAS RD
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-3428
Mailing Address - Country:US
Mailing Address - Phone:609-877-7600
Mailing Address - Fax:609-877-4540
Practice Address - Street 1:320 BEVERLY RANCOCAS RD
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-3428
Practice Address - Country:US
Practice Address - Phone:609-877-7600
Practice Address - Fax:609-877-4540
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02191100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist