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General NPI Number Information
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NPI Number | 1699546044
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Entity Type | Individual
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Provider Name | KUNJAL YESHESH PATEL
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Gender | Female
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Dates
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Enumeration Date | 01/15/2024
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 140 OLD ORANGEBURG RD
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City | ORANGEBURG
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State | NY
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Zip | 10962-1157
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Country | US
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Telephone | 845-680-5965
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Fax |
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Provider Business Mailing Address
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Address Line | 30-03 GENTNER RD
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City | FAIR LAWN
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State | NJ
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Zip | 07410-4544
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Country | US
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Telephone | 201-774-6098
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 010657-01
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License Number State | NY
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