Doctor Name: | NISHA MEGAN PATEL |
NPI Number: | 1184942278 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 9613 |
Business Practice Address: | 1900 W Park Dr Ste 280 Westborough, MA - 015813919 |
Business Phone Number: | 5087688022 |
Business Fax Number: | |
Mailing Address: | 19 Orchard St, SOUTHBOROUGH |
State: | MA |
Postal Code: | 017721455 |
Phone Number: | 5087688022 |
Fax Number: | |
NPI Enumeration Date: | 05/13/2010 |
NPI Last Update Date: | 12/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 9613 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |