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General NPI Number Information
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NPI Number | 1346456423
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Entity Type | Organization
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Legal Business Name | MONA PATEL M D LLC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 09/10/2007
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Provider Practice Location Address
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Address Line | 70 KINDERKAMACK RD SUITE 201
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City | EMERSON
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State | NJ
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Zip | 07630-1883
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Country | US
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Telephone | 201-599-9700
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Fax | 201-599-3330
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Provider Business Mailing Address
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Address Line | 70 KINDERKAMACK RD SUITE 201
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City | EMERSON
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State | NJ
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Zip | 07630-1883
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Country | US
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Telephone | 201-599-9700
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Fax | 201-599-3330
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | MONA PATEL
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Credential | M.D.
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Telephone | 201-599-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0015X
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Taxonomy Name | Psychosomatic Medicine Physician
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License Number | MA54437
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License Number State | NJ
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