Provider Demographics
NPI:1235166489
Name:PATEL, KRISHNA (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISHNA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:40 PITTSTOWN ROAD
Mailing Address - Street 2:STATE OF NEW JERSEY /HUNTERDON DEVELOPMENTAL CENTER
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-0000
Mailing Address - Country:US
Mailing Address - Phone:908-735-4031
Mailing Address - Fax:908-730-1340
Practice Address - Street 1:40 PITTSTOWN ROAD
Practice Address - Street 2:HUNTERDON DEVELOPMENTAL CENTER
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-4008
Practice Address - Country:US
Practice Address - Phone:908-735-4031
Practice Address - Fax:908-730-1340
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04200300208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
E79146Medicare UPIN
663519B1FOtherMEDICARE BILLING NUMBER