Provider Demographics
NPI:1174892848
Name:PATEL, ROSEMARY CHANDY (CRNP)
Entity type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:CHANDY
Last Name:PATEL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34TH ST. AND CIVIC CENTER BOULEVARD
Mailing Address - Street 2:WOOD BUILDING - 1ST FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104
Mailing Address - Country:US
Mailing Address - Phone:215-590-3440
Mailing Address - Fax:
Practice Address - Street 1:34TH ST. AND CIVIC CENTER BOULEVARD
Practice Address - Street 2:WOOD BUILDING - 1ST FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-590-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP011838363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics