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General NPI Number Information
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NPI Number | 1902274160
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Entity Type | Individual
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Provider Name | JAIMIE PATEL
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Gender | Female
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Dates
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Enumeration Date | 09/04/2015
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Last Update Date | 09/04/2015
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Provider Practice Location Address
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Address Line | 23001 MERRICK BLVD
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City | LAURELTON
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State | NY
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Zip | 11413-2110
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Country | US
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Telephone | 718-528-8585
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Fax |
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Provider Business Mailing Address
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Address Line | 8723 144TH ST
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City | JAMAICA
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State | NY
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Zip | 11435-3121
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Country | US
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Telephone | 646-462-1547
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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 | 060969
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License Number State | NY
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