Healthcare Provider Details

I. General information

NPI: 1265846356
Provider Name (Legal Business Name): NIRALI PATEL ANESTHESIOLOGIST ASS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 07/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 VARNUM ST NE
WASHINGTON DC
20017
US

IV. Provider business mailing address

1150 VARNUM ST NE
WASHINGTON DC
20017-2180
US

V. Phone/Fax

Practice location:
  • Phone: 202-854-4041
  • Fax: 202-854-4034
Mailing address:
  • Phone: 202-854-4812
  • Fax: 202-854-7825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberAA000074
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License NumberAA000074
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: