Provider Demographics
NPI:1346772027
Name:PATEL, NIRALI PRAVINCHANDRA (MD)
Entity type:Individual
Prefix:
First Name:NIRALI
Middle Name:PRAVINCHANDRA
Last Name:PATEL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-3814
Mailing Address - Country:US
Mailing Address - Phone:570-343-2383
Mailing Address - Fax:570-343-3923
Practice Address - Street 1:501 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505-3814
Practice Address - Country:US
Practice Address - Phone:570-230-0019
Practice Address - Fax:570-230-0013
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD470497207RB0002X, 207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine