Provider Demographics
NPI:1093827834
Name:PATEL, KARTIK (DO)
Entity Type:Individual
Prefix:
First Name:KARTIK
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:195 ROUTE 46 WEST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MINE HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07803-3164
Mailing Address - Country:US
Mailing Address - Phone:973-573-9900
Mailing Address - Fax:973-537-9901
Practice Address - Street 1:195 ROUTE 46 WEST
Practice Address - Street 2:SUITE 204
Practice Address - City:MINE HILL
Practice Address - State:NJ
Practice Address - Zip Code:07803-3164
Practice Address - Country:US
Practice Address - Phone:973-573-9900
Practice Address - Fax:973-537-9901
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-11-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS013427207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1766938OtherHIGHMARK BLUE SHIELD
820018OtherFIRST PRIORITY HEALTH
264087OtherRAILROAD MEDICARE
PA10437251Medicaid
506554OtherAETNA
96779OtherGEISINGER HEALTH PLAN
NJ116529Medicare PIN
PA096427Medicare PIN
1766938OtherHIGHMARK BLUE SHIELD