Healthcare Provider Details

I. General information

NPI: 1083946115
Provider Name (Legal Business Name): DHIREN BHARATKUMAR PATEL M.S, R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2010
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3771 103RD ST
CORONA NY
11368-3191
US

IV. Provider business mailing address

3293 BROADWAY
NEW YORK NY
10027-7909
US

V. Phone/Fax

Practice location:
  • Phone: 718-779-4450
  • Fax: 718-779-4453
Mailing address:
  • Phone: 212-281-0488
  • Fax: 212-281-0487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number047288
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02788500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: