Provider Demographics
NPI:1053762252
Name:PATEL, TATYANA
Entity type:Individual
Prefix:
First Name:TATYANA
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 1:2 CANTERBURY WAY
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2824
Mailing Address - Country:US
Mailing Address - Phone:609-602-3652
Mailing Address - Fax:
Practice Address - Street 1:1127 NJ-47
Practice Address - Street 2:SUITE 9
Practice Address - City:RIO GRANDE
Practice Address - State:NJ
Practice Address - Zip Code:08210
Practice Address - Country:US
Practice Address - Phone:609-486-2003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-29
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC064954001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical