Healthcare Provider Details

I. General information

NPI: 1578483418
Provider Name (Legal Business Name): KRIMABEN PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 MAIN ST
EMMAUS PA
18049-2749
US

IV. Provider business mailing address

99 ANITA DR
PISCATAWAY NJ
08854-2430
US

V. Phone/Fax

Practice location:
  • Phone: 610-965-2755
  • Fax: 610-421-6071
Mailing address:
  • Phone: 908-405-7336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS045922
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: