Provider Demographics
NPI:1063487759
Name:PATEL, MUKESH D (MD)
Entity Type:Individual
Prefix:
First Name:MUKESH
Middle Name:D
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 ROUTE 31
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5773
Mailing Address - Country:US
Mailing Address - Phone:908-788-6654
Mailing Address - Fax:
Practice Address - Street 1:190 ROUTE 31
Practice Address - Street 2:SUITE 100
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5773
Practice Address - Country:US
Practice Address - Phone:908-788-6654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA430222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6022707Medicaid
NJE53336Medicare UPIN
NJ585573SKVMedicare PIN