Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 25MD00362900 | NJ |
NPI | 1033644737 |
---|---|
Provider Name | Nikul Panchal |
First Address | Hackensack, NJ 07601-3247 |
Second Address | Hackensack, NJ 07601-3247 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2017 |
Last Update Date | 20/09/2021 |