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General NPI Number Information
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NPI Number | 1265064901
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Entity Type | Individual
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Provider Name | KRISHNA V PATEL PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/11/2020
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 201 BOMBAY LN
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City | ROSWELL
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State | GA
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Zip | 30076-5815
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Country | US
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Telephone | 770-686-3246
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Fax | 770-674-7366
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Provider Business Mailing Address
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Address Line | 201 BOMBAY LN
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City | ROSWELL
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State | GA
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Zip | 30076-5815
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Country | US
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Telephone | 770-686-3246
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Fax | 770-674-7366
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 024474
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 10189
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License Number State | GA
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