MEDICARE: DR. ROSHNI GANDHI PATEL D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	25MD00325000	NJ
2	213ES0103X	Foot & Ankle Surgery Podiatrist	765	NC

General Provider Information

NPI Number	:	1073871737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSHNI GANDHI PATEL D.P.M.

Provider Business Mailing Address
First Line	:	812 SOUTHSTONE DR
Second Line	:
City	:	STALLINGS
State	:	NC
Zip	:	28104-5802
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	54 BEY LEA RD
Second Line	:	SUITE 1
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-2978
Country	:	US
Telephone Number	:	732-505-4500
Fax Number	:	732-505-9787

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2012
Last Update Date	:	04/18/2026

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