Provider Demographics
NPI:1073597308
Name:PATEL, PARAG VISHNU (MD)
Entity Type:Individual
Prefix:DR
First Name:PARAG
Middle Name:VISHNU
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:PO BOX 148
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08754-0148
Mailing Address - Country:US
Mailing Address - Phone:732-606-3403
Mailing Address - Fax:
Practice Address - Street 1:20 HOSPITAL DR STE 12B
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6434
Practice Address - Country:US
Practice Address - Phone:732-240-7777
Practice Address - Fax:732-240-7710
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216558-1207RI0011X
NJ25MA07889200207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology