Healthcare Provider Details

I. General information

NPI: 1659678530
Provider Name (Legal Business Name): HEZAL ASHOK PATEL P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2011
Last Update Date: 02/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 MILL ST UNIT H3
BELLEVILLE NJ
07109-5318
US

IV. Provider business mailing address

64 BEVAN ST 2ND FLOOR
JERSEY CITY NJ
07306-3516
US

V. Phone/Fax

Practice location:
  • Phone: 973-759-1494
  • Fax:
Mailing address:
  • Phone: 412-692-1525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number033251
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: