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General NPI Number Information
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NPI Number | 1770976227
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Entity Type | Organization
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Legal Business Name | DR. NISHA PATEL & ASSOCIATES LLC
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Dates
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Enumeration Date | 03/09/2015
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Last Update Date | 03/09/2015
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Provider Practice Location Address
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Address Line | 1708 SCENIC HWY N
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City | SNELLVILLE
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State | GA
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Zip | 30078-2225
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Country | US
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Telephone | 770-736-3354
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Fax |
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Provider Business Mailing Address
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Address Line | 1708 SCENIC HWY N
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City | SNELLVILLE
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State | GA
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Zip | 30078-2225
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Country | US
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Telephone | 770-736-3354
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | NISHA PATEL
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Credential | O.D.
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Telephone | 770-304-0134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | 002796
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License Number State | GA
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