Healthcare Provider Details

I. General information

NPI: 1356903744
Provider Name (Legal Business Name): KRUPA PATEL DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2019
Last Update Date: 02/09/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HAMILTON HEALTH CENTER 110 S 17TH STREET
HARRISBURG PA
17104-1123
US

IV. Provider business mailing address

HAMILTON HEALTH CENTER 110 S 17TH STREET
HARRISBURG PA
17104-1123
US

V. Phone/Fax

Practice location:
  • Phone: 717-232-9971
  • Fax: 717-920-3039
Mailing address:
  • Phone: 717-232-9971
  • Fax: 717-920-3039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC007025
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberSC007025
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: