Healthcare Provider Details

I. General information

NPI: 1326727595
Provider Name (Legal Business Name): HARSH PATEL DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2023
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 WHITE HORSE PIKE STE 10A
HADDON HEIGHTS NJ
08035-1239
US

IV. Provider business mailing address

19 MAPLE AVE STE A
WOODBURY HEIGHTS NJ
08097-1128
US

V. Phone/Fax

Practice location:
  • Phone: 856-546-8989
  • Fax:
Mailing address:
  • Phone: 856-384-1333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: HARSH P. PATEL
Title or Position: DPM
Credential:
Phone: 267-640-6609