Individual
JALPA PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1075 CENTRAL AVE, CLARK, NJ 07066-1116
(732) 574-1399
Mailing address
1075 CENTRAL AVE, CLARK, NJ 07066-1116
(732) 574-1399
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00248000
NJ
363AM0700X
Medical Physician Assistant
25MP00248000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MP00248000
NEW JERSEY PHYSICIAN ASSISTANT ADVISORY COMMITTEE
NJ
Enumeration date
11/02/2010
Last updated
11/02/2010
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