Provider Demographics
NPI:1295097376
Name:PATEL, MEGHNA M (DO)
Entity type:Individual
Prefix:DR
First Name:MEGHNA
Middle Name:M
Last Name:PATEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 824112
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-4112
Mailing Address - Country:US
Mailing Address - Phone:215-871-6562
Mailing Address - Fax:
Practice Address - Street 1:4190 CITY AVE STE 320
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-1633
Practice Address - Country:US
Practice Address - Phone:215-871-6425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS018203204D00000X
NY278717208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No208000000XAllopathic & Osteopathic PhysiciansPediatrics