Healthcare Provider Details

I. General information

NPI: 1740512318
Provider Name (Legal Business Name): JYOTI N PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2010
Last Update Date: 02/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 E 161ST ST
BRONX NY
10451-2207
US

IV. Provider business mailing address

19514 MCLAUGHLIN AVE
HOLLIS NY
11423-1152
US

V. Phone/Fax

Practice location:
  • Phone: 718-665-1163
  • Fax: 718-665-8356
Mailing address:
  • Phone: 718-464-7229
  • Fax: 718-464-1848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number030647
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: