Individual
POONAM C PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
123 FRANKLIN CORNER RD STE 114, LAWRENCEVILLE, NJ 08648-2526
(609) 512-1690
(609) 512-1674
Mailing address
90 MATAWAN RD STE 302, MATAWAN, NJ 07747-2653
(732) 441-7177
(732) 441-7165
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00450200
NJ
363AM0700X
Medical Physician Assistant
MA058211
PA
Other
Enumeration date
07/05/2016
Last updated
02/20/2025
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