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General NPI Number Information
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NPI Number | 1437559663
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Entity Type | Individual
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Provider Name | PAYAL KSHATRIYA DDS
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Gender | Female
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Dates
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Enumeration Date | 08/25/2014
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Last Update Date | 01/20/2020
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Provider Practice Location Address
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Address Line | 6418 BERGENLINE AVE
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-1621
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Country | US
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Telephone | 201-868-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 6040 KENNEDY BLVD E APT MF
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City | WEST NEW YORK
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State | NJ
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Zip | 07093-3825
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Country | US
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Telephone | 203-727-0024
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02581900
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License Number State | NJ
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