Provider Demographics
NPI:1801285945
Name:PATEL, KIRISHMA J (DC)
Entity type:Individual
Prefix:DR
First Name:KIRISHMA
Middle Name:J
Last Name:PATEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KARISHMA
Other - Middle Name:J
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:424 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-4654
Mailing Address - Country:US
Mailing Address - Phone:848-219-2657
Mailing Address - Fax:
Practice Address - Street 1:950 TILTON RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1235
Practice Address - Country:US
Practice Address - Phone:848-219-2657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-13
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00722100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor