Provider Demographics
NPI:1376960591
Name:PATEL, KUNAL MANMOHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:KUNAL
Middle Name:MANMOHAN
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:69 ROOSEVELT DR
Mailing Address - Street 2:
Mailing Address - City:WOOD RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07075-2500
Mailing Address - Country:US
Mailing Address - Phone:973-767-7333
Mailing Address - Fax:
Practice Address - Street 1:1265 PATERSON PLANK RD STE 2E
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-3242
Practice Address - Country:US
Practice Address - Phone:201-866-7000
Practice Address - Fax:201-866-7800
Is Sole Proprietor?:No
Enumeration Date:2014-03-26
Last Update Date:2017-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09629900207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ81-2728976OtherNJ CARDIOVASCULAR INSTITUTE LLC