Provider Demographics
NPI:1841297579
Name:PATEL, NIRAJ D (DC)
Entity type:Individual
Prefix:DR
First Name:NIRAJ
Middle Name:D
Last Name:PATEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1143 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-4953
Mailing Address - Country:US
Mailing Address - Phone:610-323-6858
Mailing Address - Fax:
Practice Address - Street 1:1143 E HIGH ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-4953
Practice Address - Country:US
Practice Address - Phone:610-323-6858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009380111N00000X, 111NN1001X
NYX009993-1111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU84879Medicare UPIN
NYX3Z731Medicare ID - Type UnspecifiedMEDICARE PROVIDER #