Provider Demographics
NPI:1851889026
Name:AJVALIA, MITUL P (DPM)
Entity Type:Individual
Prefix:DR
First Name:MITUL
Middle Name:P
Last Name:AJVALIA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 S HALL CT
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-4369
Mailing Address - Country:US
Mailing Address - Phone:973-518-1450
Mailing Address - Fax:
Practice Address - Street 1:510 HAMBURG TPKE STE 108
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2033
Practice Address - Country:US
Practice Address - Phone:973-925-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-24
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00364300213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery