Provider Demographics
NPI:1710442371
Name:HARSH PATEL DPM PA
Entity Type:Organization
Organization Name:HARSH PATEL DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:HARSH
Authorized Official - Middle Name:P
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-384-1333
Mailing Address - Street 1:722 MANTUA PIKE STE 8
Mailing Address - Street 2:
Mailing Address - City:WOODBURY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08097-1141
Mailing Address - Country:US
Mailing Address - Phone:856-384-1333
Mailing Address - Fax:856-384-1297
Practice Address - Street 1:315 BROAD ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:NJ
Practice Address - Zip Code:08518-1911
Practice Address - Country:US
Practice Address - Phone:609-499-1181
Practice Address - Fax:609-499-8117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-07
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty