Healthcare Provider Details

I. General information

NPI: 1295662583
Provider Name (Legal Business Name): ROSHNI PATEL
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BROOKLINE AVE
BOSTON MA
02215-5418
US

IV. Provider business mailing address

29 HORIZON DR
CRANSTON RI
02921-2206
US

V. Phone/Fax

Practice location:
  • Phone: 617-632-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH235708
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: