Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician |
NPI | 1003271214 |
---|---|
Provider Name | Parth Patel |
First Address | Woodbridge, NJ 07095 |
Second Address | Woodbridge, NJ 07095 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2015 |
Last Update Date | 17/10/2017 |