Provider Demographics
NPI:1770767550
Name:PATEL, SHILPA R
Entity type:Individual
Prefix:MRS
First Name:SHILPA
Middle Name:R
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 1:565 W 181ST ST
Mailing Address - Street 2:181 PHARMACY
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-5004
Mailing Address - Country:US
Mailing Address - Phone:212-543-2616
Mailing Address - Fax:
Practice Address - Street 1:565 W 181ST ST
Practice Address - Street 2:181 PHARMACY
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-5004
Practice Address - Country:US
Practice Address - Phone:212-543-2616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044762183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist