Provider Demographics
NPI:1336811892
Name:PATEL, JIGNA B (OD)
Entity Type:Individual
Prefix:DR
First Name:JIGNA
Middle Name:B
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 NJ -27
Mailing Address - Street 2:SUITE 3 & 4
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824
Mailing Address - Country:US
Mailing Address - Phone:908-425-8256
Mailing Address - Fax:
Practice Address - Street 1:3000 NJ -27
Practice Address - Street 2:SUITE 3 & 4
Practice Address - City:KENDALL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08824
Practice Address - Country:US
Practice Address - Phone:908-425-8256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00708800152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist