Provider Demographics
NPI:1609147271
Name:RAVINDRA PATEL MD PA
Entity Type:Organization
Organization Name:RAVINDRA PATEL MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAVINDRA
Authorized Official - Middle Name:I
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-261-4380
Mailing Address - Street 1:5 JENNA CT
Mailing Address - Street 2:
Mailing Address - City:SCOTCH PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07076-3411
Mailing Address - Country:US
Mailing Address - Phone:732-607-1340
Mailing Address - Fax:908-322-3761
Practice Address - Street 1:42 THOCKMORTON LANE
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857
Practice Address - Country:US
Practice Address - Phone:732-607-1340
Practice Address - Fax:732-607-0552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care