Individual
MITAL PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
385 W MAIN ST, AVON, CT 06001-4357
(860) 777-1280
Mailing address
385 W MAIN ST, AVON, CT 06001-4357
(860) 777-1280
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5921
CT
363AM0700X
Medical Physician Assistant
Primary
5921
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
323462701
—
TX
Enumeration date
11/12/2010
Last updated
02/23/2023
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