Provider Demographics
NPI:1629451034
Name:PATEL, PUJA (MD)
Entity Type:Individual
Prefix:
First Name:PUJA
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 1:302 TOWNE CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-4695
Mailing Address - Country:US
Mailing Address - Phone:908-359-8613
Mailing Address - Fax:732-463-6060
Practice Address - Street 1:302 TOWNE CENTRE DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4695
Practice Address - Country:US
Practice Address - Phone:908-359-8613
Practice Address - Fax:732-463-6060
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10276700207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program