Healthcare Provider Details

I. General information

NPI: 1780174797
Provider Name (Legal Business Name): JAINI PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2018
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 ROUTE 130 STE 4
ROBBINSVILLE NJ
08691-1137
US

IV. Provider business mailing address

1140 ROUTE 130 STE 4
ROBBINSVILLE NJ
08691-1137
US

V. Phone/Fax

Practice location:
  • Phone: 609-808-3123
  • Fax: 609-808-4028
Mailing address:
  • Phone: 609-808-3123
  • Fax: 609-808-4028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA11128600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: