Provider Demographics
NPI:1083634455
Name:PATEL, PINAKIN CHIMANBHAI (MD)
Entity Type:Individual
Prefix:DR
First Name:PINAKIN
Middle Name:CHIMANBHAI
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 1:12 RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-8581
Mailing Address - Country:US
Mailing Address - Phone:732-577-7977
Mailing Address - Fax:
Practice Address - Street 1:12 RUSSELL RD
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-8581
Practice Address - Country:US
Practice Address - Phone:732-577-7977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06118200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00297416OtherRAILROAD MEDICARE
NJ6351107Medicaid
NJ0759345DTMedicare PIN
NJG08291Medicare UPIN