Provider Demographics
NPI:1952581696
Name:PATEL, SHEETAL (RPH)
Entity Type:Individual
Prefix:
First Name:SHEETAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 TIMBER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-2441
Mailing Address - Country:US
Mailing Address - Phone:631-240-4236
Mailing Address - Fax:
Practice Address - Street 1:161 CENTEREACH MALL
Practice Address - Street 2:
Practice Address - City:CENTEREACH
Practice Address - State:NY
Practice Address - Zip Code:11720-2750
Practice Address - Country:US
Practice Address - Phone:631-467-5347
Practice Address - Fax:631-467-5628
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050170-1183500000X
NJ28RI02856000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist