Provider Demographics
NPI:1912867367
Name:PATEL, KARISHMA SATISH (PA-C)
Entity type:Individual
Prefix:
First Name:KARISHMA
Middle Name:SATISH
Last Name:PATEL
Suffix:
Gender:X
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PATRIOT PKWY APT 518
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-0022
Mailing Address - Country:US
Mailing Address - Phone:210-334-7124
Mailing Address - Fax:
Practice Address - Street 1:10 PATRIOT PKWY APT 518
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-0022
Practice Address - Country:US
Practice Address - Phone:210-334-7124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA102095363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant