Provider Demographics
NPI:1275786444
Name:PATEL, PRITI S (MD)
Entity Type:Individual
Prefix:
First Name:PRITI
Middle Name:S
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 845592
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5592
Mailing Address - Country:US
Mailing Address - Phone:855-709-4531
Mailing Address - Fax:302-733-0854
Practice Address - Street 1:1 RIVERVIEW PLZ
Practice Address - Street 2:RADIATION ONCOLOGY DEPT
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1872
Practice Address - Country:US
Practice Address - Phone:732-530-2468
Practice Address - Fax:732-345-2010
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA089132002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0288349Medicaid
NJP01052673OtherRAILROAD MEDICARE
NJP01052673OtherRAILROAD MEDICARE