Healthcare Provider Details

I. General information

NPI: 1598856239
Provider Name (Legal Business Name): KIRITKUMAR PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WESTBORO STATE HOSPITAL 288 LYMAN STREET
WESTBORO MA
01581-0288
US

IV. Provider business mailing address

WESTBORO STATE HOSPITAL 288 LYMAN STREET
WESTBORO MA
01581-0288
US

V. Phone/Fax

Practice location:
  • Phone: 508-616-2346
  • Fax:
Mailing address:
  • Phone: 508-616-2346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number52919
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: