Provider Demographics
NPI:1851371660
Name:PATEL, NALIN GORDHANBHAI (MD)
Entity Type:Individual
Prefix:
First Name:NALIN
Middle Name:GORDHANBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CORNFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044-9750
Mailing Address - Country:US
Mailing Address - Phone:814-861-5000
Mailing Address - Fax:
Practice Address - Street 1:134 W MARKET ST
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-2129
Practice Address - Country:US
Practice Address - Phone:717-242-7145
Practice Address - Fax:717-437-9001
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-18
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 036345-E2084P0800X, 2084P0802X
PAMD036345E2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010528430011Medicaid
PA001052843-0010Medicaid
426309NKAMedicare ID - Type Unspecified
PA0010528430011Medicaid