Provider Demographics
NPI:1568538213
Name:PATEL, MANISHA SAURABH (MD)
Entity Type:Individual
Prefix:MRS
First Name:MANISHA
Middle Name:SAURABH
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 1:23 MONROE STREET
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3002
Mailing Address - Country:US
Mailing Address - Phone:908-722-0106
Mailing Address - Fax:908-231-1431
Practice Address - Street 1:23 MONROE ST
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-3043
Practice Address - Country:US
Practice Address - Phone:908-722-0106
Practice Address - Fax:908-231-1431
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06048100207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6289401Medicaid
F89670Medicare UPIN
530544Medicare ID - Type Unspecified