| Doctor Name: | DEVISHA PATEL |
| NPI Number: | 1154695005 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S, PA-C |
| License Number: | 25MP00270200 |
| Business Practice Address: | 459 Passaic Ave West Caldwell, NJ - 070067457 |
| Business Phone Number: | 9732767898 |
| Business Fax Number: | |
| Mailing Address: | 459 Passaic Ave, WEST CALDWELL |
| State: | NJ |
| Postal Code: | 070067457 |
| Phone Number: | 2015722581 |
| Fax Number: | |
| NPI Enumeration Date: | 02/23/2012 |
| NPI Last Update Date: | 02/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 25MP00270200 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |