Healthcare Provider Details

I. General information

NPI: 1134379142
Provider Name (Legal Business Name): KRUPA PATEL PHARM. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2008
Last Update Date: 09/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 GEORGIA AVE NW
WASHINGTON DC
20307-0003
US

IV. Provider business mailing address

3426 SNOW CLOUD LN
SILVER SPRING MD
20904-7201
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-7761
  • Fax:
Mailing address:
  • Phone: 904-233-4795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number18808
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: