Provider Demographics
NPI:1184898918
Name:PATEL, MANOJ (MD)
Entity type:Individual
Prefix:
First Name:MANOJ
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MANOJKUMAR
Other - Middle Name:MANILAL
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9 HOSPITAL DR STE B1
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6425
Mailing Address - Country:US
Mailing Address - Phone:732-363-7200
Mailing Address - Fax:866-662-4129
Practice Address - Street 1:9 HOSPITAL DR STE B1
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6425
Practice Address - Country:US
Practice Address - Phone:732-363-7200
Practice Address - Fax:866-662-4129
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08416700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ136672OtherMEDICARE ID UNSPECIFIED
NJ0187674Medicaid
NJ2797003Medicaid