Provider Demographics
NPI:1417203928
Name:PATEL, BHARGAVI JITENDRA (PA)
Entity Type:Individual
Prefix:
First Name:BHARGAVI
Middle Name:JITENDRA
Last Name:PATEL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 MORRIS TPKE STE 2H
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-2608
Mailing Address - Country:US
Mailing Address - Phone:973-232-6245
Mailing Address - Fax:973-232-6247
Practice Address - Street 1:2200 STATE ROUTE 10
Practice Address - Street 2:SUITE 106
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950
Practice Address - Country:US
Practice Address - Phone:973-232-6245
Practice Address - Fax:973-232-6247
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00289100363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical