Healthcare Provider Details

I. General information

NPI: 1083735922
Provider Name (Legal Business Name): NIMISH PATEL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 ALTAMONT AVE ECKERDS PHARMACY
SCHENECTADY NY
12303-2904
US

IV. Provider business mailing address

18064 ADDISON
PIERREFONDS QUEBEC
H9K 1N7
CA

V. Phone/Fax

Practice location:
  • Phone: 518-355-2008
  • Fax: 518-477-7907
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number000202
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: