Provider Demographics
NPI:1902042112
Name:CINNAMINSON PRIMARY CARE
Entity Type:Organization
Organization Name:CINNAMINSON PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:KALPESHKUMAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-303-8500
Mailing Address - Street 1:2800 ROUTE 130 N
Mailing Address - Street 2:SUITE 102, NEW ALBANY PROF BLDG
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-3035
Mailing Address - Country:US
Mailing Address - Phone:856-303-8500
Mailing Address - Fax:856-303-8501
Practice Address - Street 1:2800 ROUTE 130 N
Practice Address - Street 2:SUITE 102, NEW ALBANY PROF BLDG
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-3035
Practice Address - Country:US
Practice Address - Phone:856-303-8500
Practice Address - Fax:856-303-8501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08404600261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care