MEDICARE: MRS. SHILPA R PATEL

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	044762	NY

General Provider Information

NPI Number	:	1770767550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHILPA R PATEL

Provider Business Mailing Address
First Line	:	565 W 181ST ST
Second Line	:	181 PHARMACY
City	:	NEW YORK
State	:	NY
Zip	:	10033-5004
Country	:	US
Telephone Number	:	212-543-2616
Fax Number	:

Provider Business Practice Location Address
First Line	:	565 W 181ST ST
Second Line	:	181 PHARMACY
City	:	NEW YORK
State	:	NY
Zip	:	10033-5004
Country	:	US
Telephone Number	:	212-543-2616
Fax Number	:

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

Provider Enumeration Date	:	12/28/2007
Last Update Date	:	12/28/2007

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