Provider Demographics
NPI:1629500012
Name:BIJAL PATEL LLC
Entity Type:Organization
Organization Name:BIJAL PATEL LLC
Other - Org Name:LUX THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED MARRIAGE AND FAMILY THERAP
Authorized Official - Prefix:
Authorized Official - First Name:BIJAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:856-712-0137
Mailing Address - Street 1:70 PARK ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-5907
Mailing Address - Country:US
Mailing Address - Phone:856-712-0137
Mailing Address - Fax:
Practice Address - Street 1:70 PARK ST
Practice Address - Street 2:SUITE 104
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-5907
Practice Address - Country:US
Practice Address - Phone:856-712-0137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FI001811700106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty