Provider Demographics
NPI:1972826733
Name:PATEL, MAHESH N
Entity Type:Individual
Prefix:
First Name:MAHESH
Middle Name:N
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299-305 WHITE STREET
Mailing Address - Street 2:CVS PHARMACY
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810
Mailing Address - Country:US
Mailing Address - Phone:203-790-9485
Mailing Address - Fax:
Practice Address - Street 1:299 WHITE ST
Practice Address - Street 2:CVS PHARMACY
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6934
Practice Address - Country:US
Practice Address - Phone:203-790-9485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054253183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist