Provider Demographics
NPI:1306939509
Name:PATEL, KHYATI PRAVIN (DC)
Entity type:Individual
Prefix:MISS
First Name:KHYATI
Middle Name:PRAVIN
Last Name:PATEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 ROUTE 47 APT 1
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:NJ
Mailing Address - Zip Code:08242-1401
Mailing Address - Country:US
Mailing Address - Phone:609-886-8585
Mailing Address - Fax:609-886-8540
Practice Address - Street 1:1501 ROUTE 47
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:NJ
Practice Address - Zip Code:08242-1401
Practice Address - Country:US
Practice Address - Phone:609-886-8585
Practice Address - Fax:609-886-8540
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00651400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor