Healthcare Provider Details

I. General information

NPI: 1952716391
Provider Name (Legal Business Name): BIJAL PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2014
Last Update Date: 12/20/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 JUSTIN DRIVE
DANVILLE PA
17821-2552
US

IV. Provider business mailing address

35 JUSTIN DRIVE
DANVILLE PA
17821-2552
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6094
  • Fax: 570-271-5845
Mailing address:
  • Phone: 570-271-6094
  • Fax: 570-271-5845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number289681
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD472749
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: