Provider Demographics
NPI:1053599738
Name:PATEL, ALPA RONAK
Entity type:Individual
Prefix:
First Name:ALPA
Middle Name:RONAK
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 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-7130
Mailing Address - Fax:856-355-7131
Practice Address - Street 1:601 ROUTE 73 N STE 101
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-3472
Practice Address - Country:US
Practice Address - Phone:856-355-7130
Practice Address - Fax:856-355-7131
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00157000363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical