Healthcare Provider Details

I. General information

NPI: 1326471442
Provider Name (Legal Business Name): CAMILLE PATEL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2013
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVENUE - FARLEY 4 BOSTON CHILDREN'S HOSPITAL, KIDNEY TRANSPLANT PROGRAM
BOSTON MA
02115
US

IV. Provider business mailing address

35 WORCESTER ST UNIT 3
BOSTON MA
02118-3371
US

V. Phone/Fax

Practice location:
  • Phone: 617-355-7636
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2271348
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: