Provider Demographics
NPI:1952635781
Name:PATEL, NIKESH (MD)
Entity Type:Individual
Prefix:
First Name:NIKESH
Middle Name:
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 1:2 CALADIUM CT
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-2758
Mailing Address - Country:US
Mailing Address - Phone:325-706-3537
Mailing Address - Fax:732-640-8991
Practice Address - Street 1:2 CALADIUM CT
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854
Practice Address - Country:US
Practice Address - Phone:732-570-6353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-26
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08651600207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30212213Medicaid
NH30212213Medicaid