Healthcare Provider Details

I. General information

NPI: 1013303460
Provider Name (Legal Business Name): DHARINI PATEL RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 04/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10644 SAINT THOMAS DR
PHILADELPHIA PA
19116-3890
US

IV. Provider business mailing address

10644 SAINT THOMAS DR
PHILADELPHIA PA
19116-3890
US

V. Phone/Fax

Practice location:
  • Phone: 267-901-3117
  • Fax:
Mailing address:
  • Phone: 267-901-3117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI03684100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: