MEDICARE: MS. CHINMAYEE PATEL RD,LDN

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	133V00000X	Registered Dietitian	959792	PA

General Provider Information

NPI Number	:	1770420903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHINMAYEE PATEL RD,LDN

Provider Business Mailing Address
First Line	:	101 E GLENOLDEN AVE APT 202
Second Line	:
City	:	GLENOLDEN
State	:	PA
Zip	:	19036-2156
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 E GLENOLDEN AVE APT 202
Second Line	:
City	:	GLENOLDEN
State	:	PA
Zip	:	19036-2156
Country	:	US
Telephone Number	:	610-592-7082
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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