Provider Demographics
NPI:1558633719
Name:PATANKAR, AVNI (AUD)
Entity Type:Individual
Prefix:
First Name:AVNI
Middle Name:
Last Name:PATANKAR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 E MAPLE ST STE 306
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2657
Mailing Address - Country:US
Mailing Address - Phone:404-375-5363
Mailing Address - Fax:
Practice Address - Street 1:407 E MAPLE ST STE 306
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2657
Practice Address - Country:US
Practice Address - Phone:404-375-5363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-03
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2788231H00000X
GAAUD003896231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist