Provider Demographics
NPI:1790705473
Name:DAVE, PARUL (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:PARUL
Middle Name:
Last Name:DAVE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 STATE ROUTE 31
Mailing Address - Street 2:STE 111
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4953
Mailing Address - Country:US
Mailing Address - Phone:908-685-1887
Mailing Address - Fax:908-685-0162
Practice Address - Street 1:71 ROUTE 206
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4142
Practice Address - Country:US
Practice Address - Phone:908-685-1887
Practice Address - Fax:908-685-0162
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 19576363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA 19576Medicaid