Provider Demographics
NPI:1750699500
Name:PATEL, SONAL (OD)
Entity type:Individual
Prefix:
First Name:SONAL
Middle Name:
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 1:1560 GARRETT RD STE F
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-4516
Mailing Address - Country:US
Mailing Address - Phone:610-623-0039
Mailing Address - Fax:610-623-2840
Practice Address - Street 1:1560 GARRETT RD STE F
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-4516
Practice Address - Country:US
Practice Address - Phone:610-623-0039
Practice Address - Fax:610-623-2840
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003341152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty