Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 46TR00293200 | NJ |
NPI | 1588112601 |
---|---|
Provider Name | Miss Darshana Patel |
First Address | Brick, NJ 08724-7041 |
Second Address | Tinton Falls, NJ 07753-7758 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2016 |
Last Update Date | 18/09/2016 |