Active NPI
Kanan S. Patrawalla, M.D.
- Psychiatry Physician
- Summit, NJ
National Provider Identifier
1407959281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MA35034
- Practice address
- 33 Overlook Rd.
Suite 210
Summit, NJ 07901 - Phone
- (908) 598-0390
- Fax
- (908) 273-0815
- NPI assigned
- Sep 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MA35034 | NJ | Primary |
Addresses
Primary practice location
33 Overlook Rd.
Suite 210
Summit, NJ 07901
Mailing address
33 Overlook Rd.
Ste. 210
Summit, NJ 07901
Phone (908) 598-0390
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA35034 | NJ | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240876800000",
"number": "1407959281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 OVERLOOK RD.",
"address_2": "STE. 210",
"city": "SUMMIT",
"state": "NJ",
"postal_code": "07901",
"telephone_number": "908-598-0390",
"fax_number": "908-273-0815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 OVERLOOK RD.",
"address_2": "SUITE 210",
"city": "SUMMIT",
"state": "NJ",
"postal_code": "07901",
"telephone_number": "908-598-0390",
"fax_number": "908-273-0815"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRAWALLA",
"first_name": "KANAN",
"middle_name": "S.",
"name_prefix": "Mrs.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-06",
"last_updated": "2009-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NJ",
"license": "MA35034",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Summit, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.