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NPI 1083176325

NPI 1083176325 : LOPABEN PATEL : LANGHORNE, PA

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General NPI Number Information
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    NPI Number           |    1083176325
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    Entity Type          |    Individual 
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    Provider Name        |    LOPABEN PATEL
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/04/2019
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    Last Update Date     |    04/04/2019
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Provider Practice Location Address
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    Address Line         |    380 OXFORD VALLEY RD 
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    City                 |    LANGHORNE
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    State                |    PA
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    Zip                  |    19047-8304
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    Country              |    US
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    Telephone            |    215-949-5000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2114 FULMER ST 
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    City                 |    PHILADELPHIA
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    State                |    PA
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    Zip                  |    19115-3311
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    Country              |    US
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    Telephone            |    215-559-4847
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363AM0700X
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    Taxonomy Name        |    Medical Physician Assistant
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    License Number       |    MA060549
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    License Number State |    PA
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Taxonomy #2
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    OA004784
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    License Number State |    PA
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