Healthcare Provider Details

I. General information

NPI: 1265896369
Provider Name (Legal Business Name): HARSH HARISHBHAI PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2016
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N ACADEMY AVE
DANVILLE PA
17822-2139
US

IV. Provider business mailing address

4266 PHLOX PL APT B4
FLUSHING NY
11355-2139
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6389
  • Fax: 570-271-6021
Mailing address:
  • Phone: 848-482-6076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD480472
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD480472
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: