Provider Demographics
NPI:1205940392
Name:PATEL, CHIRAG V (MD)
Entity type:Individual
Prefix:
First Name:CHIRAG
Middle Name:V
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 1:601 EWING ST
Mailing Address - Street 2:STE C 17
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2757
Mailing Address - Country:US
Mailing Address - Phone:609-800-2393
Mailing Address - Fax:
Practice Address - Street 1:601 EWING ST
Practice Address - Street 2:STE C 17
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2757
Practice Address - Country:US
Practice Address - Phone:609-800-2393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35877207W00000X
IL036119682207W00000X
NJ25MA08820200207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0533210001OtherDMERC
ILIL3270440Medicare PIN
I65795Medicare UPIN
IL0533210001OtherDMERC