Provider Demographics
NPI:1932242732
Name:PATEL, GIRISH RASIKLAL (REGPHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:GIRISH
Middle Name:RASIKLAL
Last Name:PATEL
Suffix:
Gender:M
Credentials:REGPHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ELMWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-1007
Mailing Address - Country:US
Mailing Address - Phone:516-997-5798
Mailing Address - Fax:914-664-0857
Practice Address - Street 1:105 STEVENS AVE
Practice Address - Street 2:
Practice Address - City:MT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2686
Practice Address - Country:US
Practice Address - Phone:914-664-0300
Practice Address - Fax:914-664-0857
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033494-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY033494-1OtherLICENSE NUMBER