Healthcare Provider Details

I. General information

NPI: 1902437643
Provider Name (Legal Business Name): HARSH PATEL DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2020
Last Update Date: 06/14/2024
Certification Date: 06/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 FRIES MILL RD STE A1
TURNERSVILLE NJ
08012-2015
US

IV. Provider business mailing address

19 MAPLE AVE
WOODBURY HEIGHTS NJ
08097-1128
US

V. Phone/Fax

Practice location:
  • Phone: 856-384-1333
  • Fax: 856-384-1297
Mailing address:
  • Phone: 856-384-1333
  • Fax: 856-384-1297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

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