Provider Demographics
NPI:1447354477
Name:PATEL, MAHENDRA D (RPH)
Entity type:Individual
Prefix:MR
First Name:MAHENDRA
Middle Name:D
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 1:37 HARDING DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-2130
Mailing Address - Country:US
Mailing Address - Phone:973-882-8127
Mailing Address - Fax:973-882-8127
Practice Address - Street 1:37 HARDING DR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07004-2130
Practice Address - Country:US
Practice Address - Phone:973-882-8127
Practice Address - Fax:973-882-8127
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028966183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist