Provider Demographics
NPI:1174330773
Name:PATEL, VRUNDA
Entity type:Individual
Prefix:
First Name:VRUNDA
Middle Name:
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 1:211 BEECH LN
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-4033
Mailing Address - Country:US
Mailing Address - Phone:516-808-5858
Mailing Address - Fax:442-257-6912
Practice Address - Street 1:553 BECKETT RD
Practice Address - Street 2:
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-1565
Practice Address - Country:US
Practice Address - Phone:609-455-1576
Practice Address - Fax:609-623-2667
Is Sole Proprietor?:No
Enumeration Date:2024-12-17
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15221100363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology