Provider Demographics
NPI:1770639783
Name:PATEL, GITA (MS RD CDE LD)
Entity Type:Individual
Prefix:MS
First Name:GITA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MS RD CDE LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 PARTRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ETNA
Mailing Address - State:NH
Mailing Address - Zip Code:03750-4400
Mailing Address - Country:US
Mailing Address - Phone:603-643-3930
Mailing Address - Fax:603-653-0222
Practice Address - Street 1:7 PARTRIDGE RD
Practice Address - Street 2:
Practice Address - City:ETNA
Practice Address - State:NH
Practice Address - Zip Code:03750-4400
Practice Address - Country:US
Practice Address - Phone:603-643-3930
Practice Address - Fax:603-653-0222
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH675280OtherCIGNA HEALTHCARE
NH27Y004601NH01OtherANTHEM BC BS
NHPATE 59946OtherBC BS VT
NHAA59618OtherHARVARD PILGRIM
NH675280OtherCIGNA HEALTHCARE