Provider Demographics
NPI:1205098597
Name:PATEL, PRIYA R (MD)
Entity type:Individual
Prefix:
First Name:PRIYA
Middle Name:R
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 1:227 LAUREL RD STE 300
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-8303
Mailing Address - Country:US
Mailing Address - Phone:856-669-6050
Mailing Address - Fax:856-528-3117
Practice Address - Street 1:731 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-4783
Practice Address - Country:US
Practice Address - Phone:973-736-1100
Practice Address - Fax:973-736-1134
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT193453207V00000X
NJ25MA09306900207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology