Healthcare Provider Details

I. General information

NPI: 1861290298
Provider Name (Legal Business Name): PRIYA PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 CHESAPEAKE RD
MONMOUTH JUNCTION NJ
08852-3077
US

IV. Provider business mailing address

15 CHESAPEAKE RD
MONMOUTH JUNCTION NJ
08852-3077
US

V. Phone/Fax

Practice location:
  • Phone: 732-599-4691
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1861290298
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: