Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 22DI02593100 | NJ |
Y | 1223P0221X | Pediatric Dentist | 22DI02593100 | NJ |
NPI | 1003226432 |
---|---|
Provider Name | Dr. Binni Patel |
First Address | Edison, NJ 08817-4305 |
Second Address | Avon By The Sea, NJ 07717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2014 |
Last Update Date | 23/08/2018 |