MEDICARE: MAYFAIR FAMILY CHIROPRACTIC CENTER INC.

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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1770149452
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAYFAIR FAMILY CHIROPRACTIC CENTER INC.

Provider Business Mailing Address
First Line	:	1136 S 26TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-3849
Country	:	US
Telephone Number	:	856-904-3061
Fax Number	:

Provider Business Practice Location Address
First Line	:	3301 RYAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-4301
Country	:	US
Telephone Number	:	856-904-3061
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TARAK NAVIN PATEL
Credential	:	DC
Telephone Number	:	856-904-3061

Provider Enumeration Date	:	05/17/2019
Last Update Date	:	02/28/2023

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