=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851371660
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NALIN GORDHANBHAI PATEL MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/18/2006
-----------------------------------------------------
Last Update Date | 03/17/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 134 W MARKET ST
-----------------------------------------------------
City | LEWISTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17044-2129
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-242-7145
-----------------------------------------------------
Fax | 717-437-9001
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 CORNFIELD CIR
-----------------------------------------------------
City | LEWISTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17044-9750
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 814-861-5000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | MD 036345-E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2084P0802X
-----------------------------------------------------
Taxonomy Name | Addiction Psychiatry Physician
-----------------------------------------------------
License Number | MD 036345-E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 2084P0804X
-----------------------------------------------------
Taxonomy Name | Child & Adolescent Psychiatry Physician
-----------------------------------------------------
License Number | MD036345E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------