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NPI Code Detail

MEDICARE: JENNY PATEL PA

MEDICARE:   JENNY  PATEL  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantMA057735PA

General Provider Information

NPI Number : 1275950545
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNY PATEL PA
Provider Business Mailing Address
First Line : 7000 STONEWOOD DR 151
Second Line :
City : WEXFORD
State : PA
Zip : 15090-7376
Country : US
Telephone Number : 724-933-0300
Fax Number : 724-933-0456
Provider Business Practice Location Address
First Line : 537 RIVERSIDE AVE
Second Line :
City : SOMERSET
State : MA
Zip : 02725-2843
Country : US
Telephone Number : 774-644-6694
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2014
Last Update Date : 09/16/2015

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Directions to “ JENNY PATEL PA” Practice Location

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