Healthcare Provider Details

I. General information

NPI: 1578856787
Provider Name (Legal Business Name): VINUBHAI D PATEL RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2011
Last Update Date: 05/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

249 GRAHAM AVE
BROOKLYN NY
11206-1201
US

IV. Provider business mailing address

249 GRAHAM AVE
BROOKLYN NY
11206-1201
US

V. Phone/Fax

Practice location:
  • Phone: 718-384-6630
  • Fax: 718-384-3331
Mailing address:
  • Phone: 718-384-6630
  • Fax: 718-384-3331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number043626-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number00894248
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: