Healthcare Provider Details

I. General information

NPI: 1841816451
Provider Name (Legal Business Name): TRUSHA MUKESHKUMAR PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2020
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 W PARK AVE BLDG B
OCEAN NJ
07712-7272
US

IV. Provider business mailing address

804 W PARK AVE BLDG B
OCEAN NJ
07712-7272
US

V. Phone/Fax

Practice location:
  • Phone: 732-531-0010
  • Fax: 732-493-0903
Mailing address:
  • Phone: 732-531-0010
  • Fax: 732-493-0903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1015169
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: