Provider Demographics
NPI:1619933306
Name:PATEL, MINAL (MD)
Entity Type:Individual
Prefix:
First Name:MINAL
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 1:2087 KLOCKNER RD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690
Mailing Address - Country:US
Mailing Address - Phone:609-631-7108
Mailing Address - Fax:609-586-3161
Practice Address - Street 1:2087 KLOCKNER RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690
Practice Address - Country:US
Practice Address - Phone:609-631-7108
Practice Address - Fax:609-586-3161
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05759700207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
F75709Medicare UPIN
NJ591433Medicare ID - Type Unspecified