Healthcare Provider Details

I. General information

NPI: 1316494677
Provider Name (Legal Business Name): BIANCA KIRIT PATEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2016
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5999 BURKE COMMONS RD
BURKE VA
22015-2880
US

IV. Provider business mailing address

5999 BURKE COMMONS RD
BURKE VA
22015-2880
US

V. Phone/Fax

Practice location:
  • Phone: 866-530-8778
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101278663
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: