Provider Demographics
NPI:1467698944
Name:PATEL, SHITAL (MD)
Entity Type:Individual
Prefix:DR
First Name:SHITAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 RIVERS EDGE DR
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1369
Mailing Address - Country:US
Mailing Address - Phone:732-741-8448
Mailing Address - Fax:
Practice Address - Street 1:17 BROAD ST
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-1703
Practice Address - Country:US
Practice Address - Phone:732-780-1601
Practice Address - Fax:732-780-1936
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07760000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine