Provider Demographics
NPI:1235507542
Name:PATEL, DHARA H (PA-C)
Entity Type:Individual
Prefix:
First Name:DHARA
Middle Name:H
Last Name:PATEL
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:30B VREELAND RD 200
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1926
Mailing Address - Country:US
Mailing Address - Phone:973-660-9334
Mailing Address - Fax:973-660-9779
Practice Address - Street 1:94 OLD SHORT HILLS RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-5512
Practice Address - Fax:973-322-8165
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2015-11-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY018903-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant