Provider Demographics
NPI:1154567204
Name:CINNAMINSON PRIMARY CARE LLC
Entity type:Organization
Organization Name:CINNAMINSON PRIMARY CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:KALPESHKUMAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-303-8500
Mailing Address - Street 1:2800 ROUTE 130 N
Mailing Address - Street 2:SUITE 102, NEW ALBANY PROF BLDG
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-3035
Mailing Address - Country:US
Mailing Address - Phone:856-303-8500
Mailing Address - Fax:856-303-8501
Practice Address - Street 1:2800 ROUTE 130 N
Practice Address - Street 2:SUITE 102, NEW ALBANY PROF BLDG
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-3035
Practice Address - Country:US
Practice Address - Phone:856-303-8500
Practice Address - Fax:856-303-8501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-19
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty