Healthcare Provider Details

I. General information

NPI: 1306771274
Provider Name (Legal Business Name): ROSHNI M PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 TULIP DR APT 3G
FORDS NJ
08863-1136
US

IV. Provider business mailing address

5 TULIP DR APT 3G
FORDS NJ
08863-1136
US

V. Phone/Fax

Practice location:
  • Phone: 732-500-6054
  • Fax:
Mailing address:
  • Phone: 732-500-6054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR00988000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: