Provider Demographics
NPI:1063010940
Name:PATEL, SHRUTI SATISH (DNP, APN-BC)
Entity Type:Individual
Prefix:DR
First Name:SHRUTI
Middle Name:SATISH
Last Name:PATEL
Suffix:
Gender:F
Credentials:DNP, APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MERIDIAN RD
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2242
Mailing Address - Country:US
Mailing Address - Phone:732-663-0300
Mailing Address - Fax:732-663-0301
Practice Address - Street 1:298 APPLEGARTH RD STE G
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-3822
Practice Address - Country:US
Practice Address - Phone:732-663-0300
Practice Address - Fax:732-663-0301
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01065400363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NR18079200OtherNJ REGISTERED PROFESSIONAL NURSE LICENSE
NJ26NJ01065400OtherNJ APN LICENSE