Provider Demographics
NPI:1831358399
Name:PATEL, HASMUKHKUMAR (RPH)
Entity type:Individual
Prefix:
First Name:HASMUKHKUMAR
Middle Name:
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 1:4516 BROOKS BLVD
Mailing Address - Street 2:
Mailing Address - City:MARCY
Mailing Address - State:NY
Mailing Address - Zip Code:13403-2640
Mailing Address - Country:US
Mailing Address - Phone:315-717-6348
Mailing Address - Fax:
Practice Address - Street 1:42 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-3004
Practice Address - Country:US
Practice Address - Phone:518-725-4400
Practice Address - Fax:518-725-4700
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist