Provider Demographics
NPI:1659515302
Name:PATEL, MELVINA
Entity Type:Individual
Prefix:
First Name:MELVINA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1348 SAINT GEORGES AVE
Mailing Address - Street 2:
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-1134
Mailing Address - Country:US
Mailing Address - Phone:732-795-2721
Mailing Address - Fax:
Practice Address - Street 1:1348 SAINT GEORGES AVE
Practice Address - Street 2:
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001-1134
Practice Address - Country:US
Practice Address - Phone:732-795-2721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-25
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY265682207R00000X
NJ25MA11272800207RB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine