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General NPI Number Information
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NPI Number | 1760880629
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Entity Type | Individual
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Provider Name | VIJAL PATEL PA
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Gender | Female
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Dates
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Enumeration Date | 12/09/2014
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 3250 STATE ROUTE 27 STE 102
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City | KENDALL PARK
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State | NJ
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Zip | 08824-1550
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Country | US
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Telephone | 732-925-3449
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Fax |
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Provider Business Mailing Address
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Address Line | 3250 STATE ROUTE 27 STE 102
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City | KENDALL PARK
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State | NJ
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Zip | 08824-1550
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00355600
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License Number State | NJ
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