Healthcare Provider Details

I. General information

NPI: 1427607472
Provider Name (Legal Business Name): HARSH PATEL DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2019
Last Update Date: 01/31/2020
Certification Date: 01/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 EAST EVESHAM ROAD SUITE 302
VOORHEES TOWNSHIP NJ
08043-4503
US

IV. Provider business mailing address

722 MANTUA PIKE STE 8
WOODBURY HEIGHTS NJ
08097-1141
US

V. Phone/Fax

Practice location:
  • Phone: 856-770-1313
  • Fax: 856-770-1297
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: 856-770-1313