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General NPI Number Information
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NPI Number | 1205263571
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Entity Type | Individual
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Provider Name | LISA PATEL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/02/2013
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 758 ARTHUR KILL RD
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City | STATEN ISLAND
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State | NY
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Zip | 10312-2121
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Country | US
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Telephone | 718-317-5085
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Fax |
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Provider Business Mailing Address
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Address Line | 94 DEVONSHIRE DR
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-3634
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Country | US
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Telephone | 516-640-4629
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 058630
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License Number State | NY
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