Provider Demographics
NPI:1669480331
Name:PATEL, JENNIFER D (DO)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:D
Last Name:PATEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3131 WALNUT ST
Mailing Address - Street 2:UNIT #630
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3415
Mailing Address - Country:US
Mailing Address - Phone:347-526-7197
Mailing Address - Fax:
Practice Address - Street 1:1501 LANSDOWNE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1333
Practice Address - Country:US
Practice Address - Phone:610-534-6230
Practice Address - Fax:610-534-6166
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2010-06-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA228141207R00000X
PAOS014386207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine