Provider Demographics
NPI:1538123542
Name:PATEL, GAURANG (MD)
Entity Type:Individual
Prefix:
First Name:GAURANG
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:26 FIREMANS MEMORIAL DRIVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970
Mailing Address - Country:US
Mailing Address - Phone:800-750-8616
Mailing Address - Fax:845-362-8474
Practice Address - Street 1:16 POCONO RD 217
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2907
Practice Address - Country:US
Practice Address - Phone:800-750-8616
Practice Address - Fax:845-362-8474
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2023-06-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07928600207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0111619Medicaid
25MA07434900OtherMEDICAL LICENSE