Provider Demographics
NPI:1871681056
Name:PATEL, MINAL (PA)
Entity Type:Individual
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First Name:MINAL
Middle Name:
Last Name:PATEL
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Gender:F
Credentials:PA
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Mailing Address - Street 1:1011 REED AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-2002
Mailing Address - Country:US
Mailing Address - Phone:610-374-4401
Mailing Address - Fax:610-374-7140
Practice Address - Street 1:1011 REED AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-2002
Practice Address - Country:US
Practice Address - Phone:610-374-4401
Practice Address - Fax:610-374-7140
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2014-02-11
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Provider Licenses
StateLicense IDTaxonomies
PAMA003329L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS89147Medicare UPIN
PA169786ES4Medicare PIN