Provider Demographics
NPI:1063298438
Name:PATEL-DILWALI, KOMAL R (CNM, WHNP-BC)
Entity type:Individual
Prefix:
First Name:KOMAL
Middle Name:R
Last Name:PATEL-DILWALI
Suffix:
Gender:F
Credentials:CNM, WHNP-BC
Other - Prefix:
Other - First Name:KOMAL
Other - Middle Name:D
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:66 LYDIA DR
Mailing Address - Street 2:
Mailing Address - City:GUTTENBERG
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-8368
Mailing Address - Country:US
Mailing Address - Phone:781-507-5926
Mailing Address - Fax:
Practice Address - Street 1:66 LYDIA DR
Practice Address - Street 2:
Practice Address - City:GUTTENBERG
Practice Address - State:NJ
Practice Address - Zip Code:07093-8368
Practice Address - Country:US
Practice Address - Phone:781-507-5926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25ME00083900176B00000X
NJ26NJ14947300363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No176B00000XOther Service ProvidersMidwife