Provider Demographics
NPI:1780238154
Name:PATEL, RUTVIJ RAMESHBHAI (RPH)
Entity type:Individual
Prefix:MR
First Name:RUTVIJ
Middle Name:RAMESHBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3822
Mailing Address - Country:US
Mailing Address - Phone:857-445-1469
Mailing Address - Fax:
Practice Address - Street 1:1349 COMMONWEALTH AVE
Practice Address - Street 2:
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-3301
Practice Address - Country:US
Practice Address - Phone:617-254-5900
Practice Address - Fax:617-254-5908
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH238598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist