Provider Demographics
NPI:1720044043
Name:P C PATEL MD D IM PA
Entity Type:Organization
Organization Name:P C PATEL MD D IM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAVINSHAI
Authorized Official - Middle Name:C
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-827-2442
Mailing Address - Street 1:PO BOX 324
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:07416
Mailing Address - Country:US
Mailing Address - Phone:973-827-2442
Mailing Address - Fax:973-827-2669
Practice Address - Street 1:ROUTE 94 AND OXBOW LANE
Practice Address - Street 2:NORTH CHURCH PROF CENTRE UNIT 2
Practice Address - City:FRANKLIN
Practice Address - State:NJ
Practice Address - Zip Code:07416
Practice Address - Country:US
Practice Address - Phone:973-827-2442
Practice Address - Fax:973-827-2669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2800101Medicaid
148148Medicare ID - Type Unspecified
NJD96524Medicare UPIN