Basic Information
| Provider Information | |||||||||
| NPI: | 1730462573 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | PINAL | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4021 PINEY GAP DR | ||||||||
| Address2: | |||||||||
| City: | CARY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275197508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3862355766 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10010 FALLS OF NEUSE RD | ||||||||
| Address2: | STE 12 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276148494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197668989 | ||||||||
| FaxNumber: | 9197668896 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2011 | ||||||||
| LastUpdateDate: | 03/18/2019 | ||||||||
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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 | 231H00000X | 10250 | NC | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | 1730462573 | 05 | NC | MEDICAID |