1689682239 NPI number — RAJANI J. PATEL MD LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689682239 NPI number — RAJANI J. PATEL MD LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAJANI J. PATEL MD LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689682239
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 BATH RD
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
BRISTOL
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19007-3101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-785-9055
Provider Business Mailing Address Fax Number:
215-785-9098

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 BATH RD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
BRISTOL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19007-3101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-785-9055
Provider Business Practice Location Address Fax Number:
215-785-9098
Provider Enumeration Date:
08/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PATEL
Authorized Official First Name:
RAJANI
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
215-785-9055

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  MD038199L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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