Provider Demographics
NPI:1952651648
Name:PATEL, JAYNA (CRNP)
Entity Type:Individual
Prefix:MS
First Name:JAYNA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07513-1241
Mailing Address - Country:US
Mailing Address - Phone:973-523-8083
Mailing Address - Fax:973-523-1133
Practice Address - Street 1:760 MARKET ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07513-1241
Practice Address - Country:US
Practice Address - Phone:973-523-8083
Practice Address - Fax:973-523-1133
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012259163W00000X
NJ26NJ00417100363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse