MEDICARE: MINAL PATEL PHARM D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RI03251700	NJ

General Provider Information

NPI Number	:	1023321700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MINAL PATEL PHARM D

Provider Business Mailing Address
First Line	:	14850 87TH AVE FL 2
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11435-3112
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14850 87TH AVE FL 2
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11435-3112
Country	:	US
Telephone Number	:	718-739-6019
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2010
Last Update Date	:	07/22/2010

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Directions to “ MINAL PATEL PHARM D” Practice Location

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