Healthcare Provider Details

I. General information

NPI: 1154251437
Provider Name (Legal Business Name): PRIYA PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 BRIDGE ST STE 110
DEDHAM MA
02026-1759
US

IV. Provider business mailing address

2239 WASHINGTON ST
CANTON MA
02021-1168
US

V. Phone/Fax

Practice location:
  • Phone: 224-310-8563
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: