Basic Information
Provider Information | |||||||||
NPI: | 1821435876 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | PATEL | ||||||||
FirstName: | NISHI | ||||||||
MiddleName: | HAMANT | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 3421 CONCORD RD | ||||||||
Address2: |   | ||||||||
City: | YORK | ||||||||
State: | PA | ||||||||
PostalCode: | 174029001 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7178511405 | ||||||||
FaxNumber: | 7178516969 | ||||||||
Practice Location | |||||||||
Address1: | 30 MONUMENT RD STE 1100 | ||||||||
Address2: |   | ||||||||
City: | YORK | ||||||||
State: | PA | ||||||||
PostalCode: | 174035024 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7178512441 | ||||||||
FaxNumber: | 7178513521 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/31/2013 | ||||||||
LastUpdateDate: | 08/19/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 08/19/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MT-204158 | PA | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207R00000X | 4301109499 | MI | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207R00000X | MD180330 | OR | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207R00000X | 266569 | MA | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207R00000X | MD60712861 | WA | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207R00000X | R3935 | TX | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207RC0000X | MD455151 | PA | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RC0000X | FD0259994 | PA | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207R00000X | MD455151 | PA | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine |   |
No ID Information.