Provider Demographics
NPI:1558554428
Name:PATEL, KINJAL (PA-C)
Entity Type:Individual
Prefix:
First Name:KINJAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 BERNVILLE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9453
Mailing Address - Country:US
Mailing Address - Phone:610-378-2000
Mailing Address - Fax:610-378-2799
Practice Address - Street 1:108 PLAZA DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:BLANDON
Practice Address - State:PA
Practice Address - Zip Code:19510-9475
Practice Address - Country:US
Practice Address - Phone:610-208-4650
Practice Address - Fax:610-916-2787
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056120363A00000X
NJ25MP00183200363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant