Provider Demographics
NPI:1093045197
Name:PATEL, MITUL SURESH (MD)
Entity Type:Individual
Prefix:DR
First Name:MITUL
Middle Name:SURESH
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:20 CARRINGTON CT
Mailing Address - Street 2:
Mailing Address - City:WOODCLIFF LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07677-7855
Mailing Address - Country:US
Mailing Address - Phone:201-444-5353
Mailing Address - Fax:201-444-8848
Practice Address - Street 1:20 CARRINGTON CT
Practice Address - Street 2:
Practice Address - City:WOODCLIFF LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07677-7855
Practice Address - Country:US
Practice Address - Phone:201-444-5353
Practice Address - Fax:201-444-8848
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2014-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA086896002086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery