Provider Demographics
NPI:1720593486
Name:CHANDRESH PATEL, MDPC
Entity Type:Organization
Organization Name:CHANDRESH PATEL, MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDRESH
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-499-4007
Mailing Address - Street 1:1524 POWNAL DR
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-2758
Mailing Address - Country:US
Mailing Address - Phone:215-499-4007
Mailing Address - Fax:
Practice Address - Street 1:308 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5525
Practice Address - Country:US
Practice Address - Phone:877-634-5864
Practice Address - Fax:267-239-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-04
Last Update Date:2017-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD425068207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1641433OtherCIGNA
PA1760873OtherHIGHMARK BCBS
PA16077OtherHEALTH PARTNERS
PA2425425000OtherKEYSTONE HEALTH PLAN EAST
PA30029886OtherKEYSTONE FIRST
PA7504637OtherAETNA PPO
PA101695597000Medicaid
PA1468797OtherAETNA HMO
14533OtherCIGNA HEALTH SPRING