Provider Demographics
NPI:1134866254
Name:PATEL, ARCHANA S (OD)
Entity type:Individual
Prefix:
First Name:ARCHANA
Middle Name:S
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HEATHERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SOUDERTON
Mailing Address - State:PA
Mailing Address - Zip Code:18964-1961
Mailing Address - Country:US
Mailing Address - Phone:973-680-2384
Mailing Address - Fax:
Practice Address - Street 1:6951 US HIGHWAY 9 STE 1
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3766
Practice Address - Country:US
Practice Address - Phone:732-994-0442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00723900152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist