Healthcare Provider Details

I. General information

NPI: 1386618742
Provider Name (Legal Business Name): RAJANI J PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 05/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 BATH RD SUITE 210
BRISTOL PA
19007-3101
US

IV. Provider business mailing address

501 BATH RD SUITE 210
BRISTOL PA
19007-3101
US

V. Phone/Fax

Practice location:
  • Phone: 215-785-9055
  • Fax: 215-785-9098
Mailing address:
  • Phone: 215-785-9055
  • Fax: 215-785-9098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD-038199L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: