Basic Information
| Provider Information | |||||||||
| NPI: | 1336723501 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | RUCHI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5110 OLD CHAPEL HILL RD APT 335 | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277079101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7044183064 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 MARKET ST STE 110 | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275160448 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9194465670 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2021 | ||||||||
| LastUpdateDate: | 05/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | N | Behavioral Health & Social Service Providers | Behavioral Analyst | 224Z00000X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | 106S00000X | Y |
No ID Information.