Provider Demographics
NPI:1023348687
Name:PATEL, MEERA V (MD)
Entity type:Individual
Prefix:
First Name:MEERA
Middle Name:V
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 1:22-18 BROADWAY STE 201
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-3016
Mailing Address - Country:US
Mailing Address - Phone:201-475-5050
Mailing Address - Fax:201-475-4132
Practice Address - Street 1:1500 ALPS RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3635
Practice Address - Country:US
Practice Address - Phone:973-628-8500
Practice Address - Fax:973-628-7944
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2014-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09179200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine