Provider Demographics
NPI:1760841720
Name:PATEL, MITAL (MS, OTR)
Entity Type:Individual
Prefix:
First Name:MITAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 LORI ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-8619
Mailing Address - Country:US
Mailing Address - Phone:732-725-5093
Mailing Address - Fax:
Practice Address - Street 1:44 LORI ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-8619
Practice Address - Country:US
Practice Address - Phone:732-725-5093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00341700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist