Provider Demographics
NPI:1477502193
Name:PATEL, NARENDRAKUMAR D (MD)
Entity Type:Individual
Prefix:
First Name:NARENDRAKUMAR
Middle Name:D
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NARENDRA
Other - Middle Name:D
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2115 N WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-3739
Mailing Address - Country:US
Mailing Address - Phone:908-486-0990
Mailing Address - Fax:908-925-7745
Practice Address - Street 1:2115 N WOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-3739
Practice Address - Country:US
Practice Address - Phone:908-486-0990
Practice Address - Fax:908-925-7745
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03254400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0433608Medicaid
NJ0433608Medicaid
NJPA089405Medicare ID - Type Unspecified