Individual
MR. SUPAL PATEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APN, FNP-BC
Contact information
Practice address
2177 OAK TREE RD STE 204, EDISON, NJ 08820-1082
(908) 769-4735
Mailing address
2177 OAK TREE RD STE 204, EDISON, NJ 08820-1082
(908) 769-4735
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
26NR16668400
NJ
363LF0000X
Family Nurse Practitioner
Primary
26NJ00964200
NJ
Other
Enumeration date
07/10/2018
Last updated
07/27/2021
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