Provider Demographics
NPI:1366831919
Name:PATEL, JAY CHINU (PHARMD)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:CHINU
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W 4TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-3352
Mailing Address - Country:US
Mailing Address - Phone:570-677-5509
Mailing Address - Fax:302-502-3885
Practice Address - Street 1:2500 W 4TH ST STE 1
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3352
Practice Address - Country:US
Practice Address - Phone:570-677-5509
Practice Address - Fax:302-502-3885
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2024-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0004517183500000X
PARP448396183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist