=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376875104
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HEMANT N PATEL PHARM D
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/04/2010
-----------------------------------------------------
Last Update Date | 02/04/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 866 3RD AVE
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10022-6221
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-759-9412
-----------------------------------------------------
Fax | 212-751-4986
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8625 DONGAN AVE 3C
-----------------------------------------------------
City | ELMHURST
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11373-3851
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-273-9958
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 049949
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------