Provider Demographics
NPI:1265877823
Name:PATEL, AFIYA S
Entity type:Individual
Prefix:MRS
First Name:AFIYA
Middle Name:S
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 1:15190 CIMARRON AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068
Mailing Address - Country:US
Mailing Address - Phone:651-472-9963
Mailing Address - Fax:
Practice Address - Street 1:15190 CIMARRON AVE
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-2752
Practice Address - Country:US
Practice Address - Phone:651-472-9936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN121148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist