Provider Demographics
NPI:1396951547
Name:PATEL, KOMAL P (CRNP)
Entity type:Individual
Prefix:
First Name:KOMAL
Middle Name:P
Last Name:PATEL
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Gender:F
Credentials:CRNP
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Mailing Address - Street 1:1601 WALNUT ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2944
Mailing Address - Country:US
Mailing Address - Phone:215-590-3440
Mailing Address - Fax:215-590-3986
Practice Address - Street 1:34TH & CIVIC CENTER BLVD
Practice Address - Street 2:CHILDREN'S HOSPITAL OF PHILADELPHIA
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4306
Practice Address - Country:US
Practice Address - Phone:215-590-3440
Practice Address - Fax:215-590-3986
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PASP008036363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner