Provider Demographics
NPI:1023044104
Name:PATEL, JAYENDRA N (MD, FACC)
Entity Type:Individual
Prefix:DR
First Name:JAYENDRA
Middle Name:N
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1429
Mailing Address - Country:US
Mailing Address - Phone:732-462-4100
Mailing Address - Fax:732-462-3798
Practice Address - Street 1:32 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1429
Practice Address - Country:US
Practice Address - Phone:732-462-4100
Practice Address - Fax:732-462-3798
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05982000207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG-85609Medicare UPIN