Healthcare Provider Details

I. General information

NPI: 1033165832
Provider Name (Legal Business Name): RAJNI B PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2031 N BROAD ST
LANSDALE PA
19446-1063
US

IV. Provider business mailing address

2031 N BROAD ST STE 145
LANSDALE PA
19446-1063
US

V. Phone/Fax

Practice location:
  • Phone: 215-368-1114
  • Fax: 215-368-6608
Mailing address:
  • Phone: 215-368-1114
  • Fax: 215-368-6608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD044538L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: