MEDICARE: KALPESH MAFATBHAI PATEL RPH

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	28RI02962800	NJ
2	183500000X	Pharmacist	055818	NY

General Provider Information

NPI Number	:	1992084685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALPESH MAFATBHAI PATEL RPH

Provider Business Mailing Address
First Line	:	2568 LINDEN BLVD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-4904
Country	:	US
Telephone Number	:	718-485-0070
Fax Number	:	718-485-0188

Provider Business Practice Location Address
First Line	:	2568 LINDEN BLVD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11208-4904
Country	:	US
Telephone Number	:	718-485-0070
Fax Number	:	718-485-0188

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

Provider Enumeration Date	:	08/11/2011
Last Update Date	:	03/31/2022

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