Provider Demographics
NPI:1437245354
Name:PATEL, RAMESH L (MD)
Entity Type:Individual
Prefix:
First Name:RAMESH
Middle Name:L
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:707 SO ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-2698
Mailing Address - Country:US
Mailing Address - Phone:973-761-6111
Mailing Address - Fax:973-761-4990
Practice Address - Street 1:707 SO ORANGE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07076-2698
Practice Address - Country:US
Practice Address - Phone:973-761-6111
Practice Address - Fax:973-761-4990
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA61556207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6769900Medicaid
NJ600315Medicare ID - Type Unspecified
NJ6769900Medicaid