Provider Demographics
NPI:1730112632
Name:PATEL, VINESHKUMAR K (MD)
Entity Type:Individual
Prefix:
First Name:VINESHKUMAR
Middle Name:K
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 1:436 CHRIS GAUPP DR.
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-4487
Mailing Address - Country:US
Mailing Address - Phone:609-652-0100
Mailing Address - Fax:609-652-0150
Practice Address - Street 1:2500 ENGLISH CREEK AVE.
Practice Address - Street 2:BLDG 200, SUITE 211
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234
Practice Address - Country:US
Practice Address - Phone:609-677-7776
Practice Address - Fax:609-677-7509
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA06539100207RC0000X
NJ25MA06539100207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0091456Medicaid
NJ0091456Medicaid
NJ066303CN9Medicare PIN
NJH78339Medicare UPIN