Provider Demographics
NPI:1225439748
Name:PATEL, AMY RAJ (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:RAJ
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1541 ROUTE 88 W STE A
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-2373
Mailing Address - Country:US
Mailing Address - Phone:732-836-3200
Mailing Address - Fax:732-836-3201
Practice Address - Street 1:1541 ROUTE 88 W STE A
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-2373
Practice Address - Country:US
Practice Address - Phone:732-836-3200
Practice Address - Fax:732-836-3201
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA75225207RN0300X
NJ25MA09737800207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology