Provider Demographics
NPI:1457312589
Name:PATEL, RAKESH BHOGILAL (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:RAKESH
Middle Name:BHOGILAL
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:284 N FRANKLIN TPKE
Mailing Address - Street 2:FL 2
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1629
Mailing Address - Country:US
Mailing Address - Phone:201-445-9915
Mailing Address - Fax:201-445-9916
Practice Address - Street 1:1 W RIDGEWOOD AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2359
Practice Address - Country:US
Practice Address - Phone:201-445-9915
Practice Address - Fax:201-445-9916
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA66641174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ075748Medicare ID - Type Unspecified
NJH77606Medicare UPIN