Basic Information
| Provider Information | |||||||||
| NPI: | 1871640664 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATIL | ||||||||
| FirstName: | MEENAL | ||||||||
| MiddleName: | KULKARNI | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | KULKARNI | ||||||||
| OtherFirstName: | MEENAL | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4 EVES DR STE A100 | ||||||||
| Address2: | |||||||||
| City: | MARLTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080533126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6092679400 | ||||||||
| FaxNumber: | 6092679457 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 YOUNG AVE STE 245 | ||||||||
| Address2: | |||||||||
| City: | MOORESTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080573132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6092679400 | ||||||||
| FaxNumber: | 6092679457 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2007 | ||||||||
| LastUpdateDate: | 02/09/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | 25MA09632700 | NJ | N | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 208VP0014X | 25MA09632700 | NJ | Y | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine |
No ID Information.