Provider Demographics
NPI:1972205375
Name:PATEL, PREETI KIRIT
Entity Type:Individual
Prefix:
First Name:PREETI
Middle Name:KIRIT
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 PLEASANT ST APT 24
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-1356
Mailing Address - Country:US
Mailing Address - Phone:508-736-6999
Mailing Address - Fax:
Practice Address - Street 1:1029 PLEASANT ST APT 24
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01602-1356
Practice Address - Country:US
Practice Address - Phone:508-736-6999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2316462363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily