Provider Demographics
NPI:1952867764
Name:GOHEL, UDAY (RPH)
Entity Type:Individual
Prefix:
First Name:UDAY
Middle Name:
Last Name:GOHEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1342 APPLE BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-6416
Mailing Address - Country:US
Mailing Address - Phone:215-369-0296
Mailing Address - Fax:
Practice Address - Street 1:169 W LEHIGH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-3832
Practice Address - Country:US
Practice Address - Phone:267-858-4662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-17
Last Update Date:2019-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPP038238L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist