Provider Demographics
NPI:1699138552
Name:JAIN, MONICA PATEL (MD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:PATEL
Last Name:JAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 ROUTE 168 STE A6
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-3207
Mailing Address - Country:US
Mailing Address - Phone:856-232-6500
Mailing Address - Fax:856-232-0022
Practice Address - Street 1:900 ROUTE 168 STE A6
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012
Practice Address - Country:US
Practice Address - Phone:856-232-6500
Practice Address - Fax:856-232-0022
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR4100207Q00000X
NJ25MA10614900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine