Provider Demographics
NPI:1689965097
Name:PATEL, SAURIN (OD)
Entity Type:Individual
Prefix:DR
First Name:SAURIN
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 GARRETT RD STE F
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-4516
Mailing Address - Country:US
Mailing Address - Phone:610-623-0039
Mailing Address - Fax:610-623-2840
Practice Address - Street 1:1560 GARRETT RD STE F
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-4516
Practice Address - Country:US
Practice Address - Phone:610-623-0039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3348152W00000X
NY007667152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist