Provider Demographics
NPI:1003476680
Name:PATEL, ANERI
Entity type:Individual
Prefix:
First Name:ANERI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8A HENRY STREET
Mailing Address - Street 2:APT, SUITE, FLOOR, ETC.
Mailing Address - City:MOONACHIE
Mailing Address - State:NJ
Mailing Address - Zip Code:07074-3825
Mailing Address - Country:US
Mailing Address - Phone:516-728-1167
Mailing Address - Fax:
Practice Address - Street 1:8A HENRY STREET
Practice Address - Street 2:APT, SUITE, FLOOR, ETC.
Practice Address - City:MOONACHIE
Practice Address - State:NJ
Practice Address - Zip Code:07074-3825
Practice Address - Country:US
Practice Address - Phone:516-728-1167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-17
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00533000363A00000X
NJ363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant