Provider Demographics
NPI:1134564099
Name:PATEL, JINAL MITAL (PT)
Entity type:Individual
Prefix:MRS
First Name:JINAL
Middle Name:MITAL
Last Name:PATEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3217
Mailing Address - Country:US
Mailing Address - Phone:732-881-9200
Mailing Address - Fax:
Practice Address - Street 1:804 RYDERS LN
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5849
Practice Address - Country:US
Practice Address - Phone:732-238-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01492300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist