Provider Demographics
NPI:1750965133
Name:PATEL, RAVI R (PHARM D)
Entity type:Individual
Prefix:
First Name:RAVI
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4757 LORAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-3442
Mailing Address - Country:US
Mailing Address - Phone:216-957-4942
Mailing Address - Fax:216-957-8525
Practice Address - Street 1:4757 LORAIN AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44102-3442
Practice Address - Country:US
Practice Address - Phone:216-957-4942
Practice Address - Fax:216-957-8525
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03131894183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist