Provider Demographics
NPI:1447853890
Name:PATEL, KUNAL G
Entity type:Individual
Prefix:
First Name:KUNAL
Middle Name:G
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7625 HILLVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:COOPERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18036-1649
Mailing Address - Country:US
Mailing Address - Phone:703-424-5494
Mailing Address - Fax:570-859-1013
Practice Address - Street 1:7625 HILLVIEW CIR
Practice Address - Street 2:
Practice Address - City:COOPERSBURG
Practice Address - State:PA
Practice Address - Zip Code:18036-1649
Practice Address - Country:US
Practice Address - Phone:703-424-5494
Practice Address - Fax:570-859-1013
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP44763091835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Single Specialty