Provider Demographics
NPI:1083790729
Name:PATEL, RAMBHAI C (MD)
Entity Type:Individual
Prefix:
First Name:RAMBHAI
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAMBHAI
Other - Middle Name:C
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:224 E JERSEY ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07206-2709
Mailing Address - Country:US
Mailing Address - Phone:908-351-2442
Mailing Address - Fax:908-355-6095
Practice Address - Street 1:224 E JERSEY ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07206-2709
Practice Address - Country:US
Practice Address - Phone:908-351-2442
Practice Address - Fax:908-355-6095
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03088400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3039901Medicaid
NJ461036Medicare ID - Type Unspecified
NJ3039901Medicaid