Provider Demographics
NPI:1659536720
Name:KIRIT PATEL, M.D.P.A
Entity Type:Organization
Organization Name:KIRIT PATEL, M.D.P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-757-9555
Mailing Address - Street 1:34-36 PROGRESS ST STE A6
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1197
Mailing Address - Country:US
Mailing Address - Phone:908-757-9555
Mailing Address - Fax:908-757-2312
Practice Address - Street 1:34-36 PROGRESS ST STE A6
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1197
Practice Address - Country:US
Practice Address - Phone:908-757-9555
Practice Address - Fax:908-757-2312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04536300207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1884701Medicaid
NJ1884701Medicaid
NJD96824Medicare UPIN