Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | MD467218 | PA |
NPI | 1396002820 |
---|---|
Provider Name | Priya Jayesh Patel |
First Address | Philadelphia, PA 19104-5501 |
Second Address | Philadelphia, PA 19104-5501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2012 |
Last Update Date | 13/08/2019 |