MEDICARE: DR. JALU PATEL DPM

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	N006305	NY

General Provider Information

NPI Number	:	1447497532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JALU PATEL DPM

Provider Business Mailing Address
First Line	:	294 GARRETT RD
Second Line	:
City	:	MOUNTAINSIDE
State	:	NJ
Zip	:	07092-1810
Country	:	US
Telephone Number	:	917-327-5200
Fax Number	:

Provider Business Practice Location Address
First Line	:	3112 WEBSTER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-4926
Country	:	US
Telephone Number	:	718-655-3410
Fax Number	:

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

Provider Enumeration Date	:	01/12/2009
Last Update Date	:	01/05/2015

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