Provider Demographics
NPI:1548538382
Name:PATEL, JAYNA (RPH)
Entity type:Individual
Prefix:
First Name:JAYNA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:JAYNA
Other - Middle Name:
Other - Last Name:JARIWALA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:412 ALTAS PL
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-1945
Mailing Address - Country:US
Mailing Address - Phone:804-690-6919
Mailing Address - Fax:
Practice Address - Street 1:9621 BEL AIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-5465
Practice Address - Country:US
Practice Address - Phone:410-529-2864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20635183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist