Provider Demographics
NPI:1134311756
Name:PATEL, RAJIV J (DO)
Entity Type:Individual
Prefix:DR
First Name:RAJIV
Middle Name:J
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:211 ESSEX ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-3244
Mailing Address - Country:US
Mailing Address - Phone:201-489-3888
Mailing Address - Fax:201-301-7351
Practice Address - Street 1:211 ESSEX ST
Practice Address - Street 2:SUITE 104
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-3244
Practice Address - Country:US
Practice Address - Phone:201-489-3888
Practice Address - Fax:201-301-7351
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2012-11-15
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB08289800207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ136079Medicare PIN