Provider Demographics
NPI:1831280650
Name:PATNAIK, ASIT (MD)
Entity Type:Individual
Prefix:DR
First Name:ASIT
Middle Name:
Last Name:PATNAIK
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 1:255 STARBOARD WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-6111
Mailing Address - Country:US
Mailing Address - Phone:856-727-0391
Mailing Address - Fax:
Practice Address - Street 1:1235 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:STE 316 BLDG C
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-3810
Practice Address - Country:US
Practice Address - Phone:609-581-5586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA08157800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP3815006OtherOXFORD INSURANCE COMPANY
NJ7758874OtherAETNA
NJ223709512OtherQUAL CARE
NJ2716722OtherUNITED HEALTHCARE