Provider Demographics
NPI:1821228644
Name:PATEL, POOJA (MD)
Entity Type:Individual
Prefix:DR
First Name:POOJA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-4328
Mailing Address - Country:US
Mailing Address - Phone:732-441-4251
Mailing Address - Fax:908-351-6911
Practice Address - Street 1:188 MARKET ST
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-4328
Practice Address - Country:US
Practice Address - Phone:732-441-4251
Practice Address - Fax:908-351-6911
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09206500207R00000X
PAMD447723208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist