Provider Demographics
NPI:1447227970
Name:PATEL, PRAVIN C (MD)
Entity Type:Individual
Prefix:DR
First Name:PRAVIN
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:P
Other - Middle Name:C
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 324
Mailing Address - Street 2:ROUTE 94 AND OXBOW LN STE 2
Mailing Address - City:FRANKLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:07416
Mailing Address - Country:US
Mailing Address - Phone:973-827-2442
Mailing Address - Fax:973-827-2669
Practice Address - Street 1:RT 94 & OXBOW LN
Practice Address - Street 2:UNIT 2 NORTH CHURCH PROF CENTRE
Practice Address - City:FRANKLIN
Practice Address - State:NJ
Practice Address - Zip Code:07416
Practice Address - Country:US
Practice Address - Phone:973-827-2442
Practice Address - Fax:973-827-2669
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-03
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03006600207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2800101Medicaid
NJ2800101Medicaid
NJ148148Medicare PIN