Provider Demographics
NPI:1932771318
Name:PATEL, KRIPALBEN AMRUTLAL (PA-C)
Entity Type:Individual
Prefix:
First Name:KRIPALBEN
Middle Name:AMRUTLAL
Last Name:PATEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KRIPAL
Other - Middle Name:AMRUTLAL
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:90 BERGEN ST STE 8100
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-2425
Mailing Address - Country:US
Mailing Address - Phone:201-562-7053
Mailing Address - Fax:
Practice Address - Street 1:7403 DANE CT APT A
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-4085
Practice Address - Country:US
Practice Address - Phone:201-562-7053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant