Provider Demographics
NPI:1780949404
Name:PATKAR, KASTURI (MHC)
Entity type:Individual
Prefix:
First Name:KASTURI
Middle Name:
Last Name:PATKAR
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 BRIARCLIFF RD
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-5206
Mailing Address - Country:US
Mailing Address - Phone:518-965-0056
Mailing Address - Fax:
Practice Address - Street 1:595 BETHLEHEM PIKE
Practice Address - Street 2:SUITE 106
Practice Address - City:MONTGOMERYVILLE
Practice Address - State:PA
Practice Address - Zip Code:18936-9710
Practice Address - Country:US
Practice Address - Phone:215-997-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health