Healthcare Provider Details

I. General information

NPI: 1366372252
Provider Name (Legal Business Name): JINAL PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 KOSTER BLVD APT 6B
EDISON NJ
08837-4211
US

IV. Provider business mailing address

6 KOSTER BLVD APT 6B
EDISON NJ
08837-4211
US

V. Phone/Fax

Practice location:
  • Phone: 848-247-8042
  • Fax:
Mailing address:
  • Phone: 848-247-8042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number26NJ15576600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ15576600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: