Provider Demographics
NPI:1912180837
Name:PATEL, VAISHALI K
Entity Type:Individual
Prefix:
First Name:VAISHALI
Middle Name:K
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 1:12 SYCAMORE LN
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2522
Mailing Address - Country:US
Mailing Address - Phone:516-385-2623
Mailing Address - Fax:
Practice Address - Street 1:178 NEW HYDE PARK RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-3012
Practice Address - Country:US
Practice Address - Phone:516-775-4294
Practice Address - Fax:516-775-0135
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047400-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist