Provider Demographics
NPI:1568721637
Name:PATEL, DIPAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:DIPAN
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08530-2115
Mailing Address - Country:US
Mailing Address - Phone:609-397-0691
Mailing Address - Fax:609-460-4865
Practice Address - Street 1:41 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:LAMBERTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08530-2115
Practice Address - Country:US
Practice Address - Phone:609-397-0691
Practice Address - Fax:609-460-4865
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006416213E00000X, 213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist