Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 27OA00698900 | NJ |
NPI | 1003420852 |
---|---|
Provider Name | Hirali Patel |
First Address | Rockaway, NJ 07866-1644 |
Second Address | Rockaway, NJ 07866-1644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2020 |
Last Update Date | 14/05/2021 |