Provider Demographics
NPI:1033216932
Name:DR ASHOKKUMAR B PATEL MD PC
Entity Type:Organization
Organization Name:DR ASHOKKUMAR B PATEL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASHOKKUMAR
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-429-5838
Mailing Address - Street 1:69 BERLIN ROAD
Mailing Address - Street 2:STE 1
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3572
Mailing Address - Country:US
Mailing Address - Phone:856-429-5838
Mailing Address - Fax:856-429-3470
Practice Address - Street 1:69 BERLIN ROAD
Practice Address - Street 2:STE 1
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3572
Practice Address - Country:US
Practice Address - Phone:856-429-5838
Practice Address - Fax:856-429-3470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7261705Medicaid
NJ060395Medicare ID - Type Unspecified