Provider Demographics
NPI:1770012353
Name:PATEL, KRUPALI (MD)
Entity Type:Individual
Prefix:DR
First Name:KRUPALI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 ROUTE 28
Mailing Address - Street 2:SUITE 2205
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869
Mailing Address - Country:US
Mailing Address - Phone:908-725-5530
Mailing Address - Fax:908-253-6559
Practice Address - Street 1:317 CLEVELAND AVENUE
Practice Address - Street 2:SUITE 204
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904
Practice Address - Country:US
Practice Address - Phone:732-249-8999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-07
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10903100320800000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness