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General NPI Number Information
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NPI Number | 1972747665
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Entity Type | Individual
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Provider Name | SHRUTI PATEL PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 04/24/2009
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 37 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10006-3001
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Country | US
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Telephone | 212-385-9353
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Fax |
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Provider Business Mailing Address
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Address Line | 1 HARBORSIDE PL APT 551
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City | JERSEY CITY
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State | NJ
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Zip | 07311-3923
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Country | US
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Telephone | 347-387-4215
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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 | 053103
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License Number State | NY
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