Provider Demographics
NPI:1487958872
Name:PATEL, TARUN R (RPH)
Entity type:Individual
Prefix:MR
First Name:TARUN
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 COURT NORTH DR
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-8121
Mailing Address - Country:US
Mailing Address - Phone:631-694-9176
Mailing Address - Fax:
Practice Address - Street 1:60 LAUREL HILL RD
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-2408
Practice Address - Country:US
Practice Address - Phone:203-641-3102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051066-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist