Provider Demographics
NPI:1659327922
Name:PATEL, NIRAJ (MD)
Entity Type:Individual
Prefix:MR
First Name:NIRAJ
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 W MOUNT PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-1600
Mailing Address - Country:US
Mailing Address - Phone:973-251-1177
Mailing Address - Fax:973-251-1165
Practice Address - Street 1:383 RIDGEDALE AVE
Practice Address - Street 2:
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936-1445
Practice Address - Country:US
Practice Address - Phone:973-887-0200
Practice Address - Fax:973-887-4965
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07433100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ110246554OtherRAILROAD MEDICARE
NJH77623Medicare UPIN
NJ066636Medicare ID - Type Unspecified