Provider Demographics
NPI:1851397574
Name:PATEL, PRATIK (MD)
Entity Type:Individual
Prefix:DR
First Name:PRATIK
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:11 MERIDIAN RD
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2242
Mailing Address - Country:US
Mailing Address - Phone:732-663-0300
Mailing Address - Fax:732-663-0301
Practice Address - Street 1:298 APPLEGARTH RD STE G
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-3822
Practice Address - Country:US
Practice Address - Phone:732-210-3285
Practice Address - Fax:732-242-6655
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA068459207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH55176Medicare UPIN
NJ089916ATBMedicare ID - Type Unspecified