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General NPI Number Information
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NPI Number | 1861551608
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Entity Type | Individual
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Provider Name | AMI DINESH PATEL O.D.
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Gender | Female
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1750 DEPTFORD CENTER RD
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City | WOODBURY
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State | NJ
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Zip | 08096-5222
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Country | US
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Telephone | 856-848-3162
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Fax | 856-848-5657
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Provider Business Mailing Address
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Address Line | 6 FLORABUNDA LN
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City | CINNAMINSON
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State | NJ
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Zip | 08077-4530
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Country | US
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Telephone | 856-829-1748
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Fax | 856-848-5657
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00576300
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License Number State | NJ
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