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General NPI Number Information
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NPI Number | 1366620544
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Entity Type | Individual
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Provider Name | JESIKA PATEL R.PH.
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Gender | Female
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Dates
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Enumeration Date | 02/10/2008
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Last Update Date | 02/10/2008
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Provider Practice Location Address
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Address Line | 2105 PHILADELPHIA PIKE
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City | CLAYMONT
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State | DE
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Zip | 19703-2426
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Country | US
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Telephone | 302-798-4618
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Fax | 302-798-4632
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Provider Business Mailing Address
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Address Line | 326 CLUBHOUSE LN
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City | WILMINGTON
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State | DE
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Zip | 19810-2264
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Country | US
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Telephone | 302-475-2606
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Fax | 302-475-2606
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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 | A1-0003681
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP442310
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI02743000
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202205081
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License Number State | VA
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