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Provider Information for 1518366459

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TEJAS PATEL

Gender: MALE

Individual NPI: 1518366459

Calendar   Last Updated:  2014-08-15
  Certification Date: 

Details

Name Value
NPI 1518366459
Enumeration Date 2014-08-15
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 4811 JONESTOWN RD SUITE 129
HARRISBURG, PA 17109-1745
United States

Phone: 717-526-2011 | Fax:
View Map External Link
Primary Practice Address 4811 JONESTOWN RD SUITE 129
HARRISBURG, PA 17109-1745
United States

Phone: 717-526-2011 | Fax:
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist PA DS040154