Provider Demographics
NPI:1245314913
Name:PATEL, ARCHANA M (MD)
Entity type:Individual
Prefix:
First Name:ARCHANA
Middle Name:M
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ARCHANA
Other - Middle Name:I
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:66 WEST GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701
Mailing Address - Country:US
Mailing Address - Phone:732-212-0051
Mailing Address - Fax:732-212-0713
Practice Address - Street 1:125 PATERSON ST
Practice Address - Street 2:5TH FLOOR SUITE 5200
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1962
Practice Address - Country:US
Practice Address - Phone:732-235-6561
Practice Address - Fax:732-235-6530
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04977400207R00000X, 207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ110141415OtherRAILROAD MEDICARE
NJ5372305Medicaid
NJP00133010OtherRR MCR PTAN
NJ780222259OtherHORIZON
NJ1109596OtherHORIZON NJ HEALTH
NJ1K9037OtherHEALTHNET
NJ23958OtherUNIVERSITY HEALTH PLANS
NJP1725311OtherOXFORD
NJ0312618000OtherAMERIHEALTH
NJHU0000154 01OtherAMERICHOICE
NJ2259075OtherAETNA
NJ8396147006OtherCIGNA
NJ23958OtherUNIVERSITY HEALTH PLANS
NJ8396147006OtherCIGNA
NJ479043Medicare ID - Type Unspecified