1457583767 NPI number — RESHMA RIKIN PATEL DPT

Table of content: RESHMA RIKIN PATEL DPT (NPI 1457583767)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457583767 NPI number — RESHMA RIKIN PATEL DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PATEL
Provider First Name:
RESHMA
Provider Middle Name:
RIKIN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PATEL
Provider Other First Name:
RESHMA
Provider Other Middle Name:
PRAVIN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1457583767
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
557 CRANBURY RD
Provider Second Line Business Mailing Address:
SUITE 6
Provider Business Mailing Address City Name:
EAST BRUNSWICK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08816-5419
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-698-2800
Provider Business Mailing Address Fax Number:
732-698-1828

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300A PRINCETON-HIGHTSTOWN RD.
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
EAST WINDSOR
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08520-1411
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-426-4442
Provider Business Practice Location Address Fax Number:
609-443-0910
Provider Enumeration Date:
08/20/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  40QA01283400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)