Provider Demographics
NPI:1750522504
Name:PATEL, NAINESH PREFULBHAI
Entity type:Individual
Prefix:
First Name:NAINESH
Middle Name:PREFULBHAI
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 1:675 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-4957
Mailing Address - Country:US
Mailing Address - Phone:718-387-2665
Mailing Address - Fax:718-486-8314
Practice Address - Street 1:675 GRAND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-4957
Practice Address - Country:US
Practice Address - Phone:718-387-2665
Practice Address - Fax:718-486-8314
Is Sole Proprietor?:No
Enumeration Date:2009-03-07
Last Update Date:2009-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050837-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist