Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 25MA03810400 | NJ |
NPI | 1245255496 |
---|---|
Provider Name | Dr. Rekha Patel |
First Address | Piscataway, NJ 08854-3285 |
Second Address | Piscataway, NJ 08854-3285 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 15/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7400900 | (05) | NJ |