Healthcare Provider Details

I. General information

NPI: 1700555828
Provider Name (Legal Business Name): PREYA PATEL DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2021
Last Update Date: 09/10/2021
Certification Date: 09/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 PULASKI HWY
BEAR DE
19701-1711
US

IV. Provider business mailing address

843 COLORADO DR
NEWARK DE
19713-8109
US

V. Phone/Fax

Practice location:
  • Phone: 302-300-1111
  • Fax:
Mailing address:
  • Phone: 732-877-8714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberF1-0011058
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: