Provider Demographics
NPI:1750649604
Name:PATEL, RECHAL M (RDH)
Entity Type:Individual
Prefix:MRS
First Name:RECHAL
Middle Name:M
Last Name:PATEL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3720
Mailing Address - Country:US
Mailing Address - Phone:732-318-7439
Mailing Address - Fax:
Practice Address - Street 1:200 MONROE AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3720
Practice Address - Country:US
Practice Address - Phone:732-318-7439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-29
Last Update Date:2012-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22HI00932900124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist