Provider Demographics
NPI:1336188622
Name:PATEL, HIMANSHU (MD)
Entity Type:Individual
Prefix:DR
First Name:HIMANSHU
Middle Name:
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 1:1527 STATE ROUTE 27
Mailing Address - Street 2:SUITE # 1600
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3979
Mailing Address - Country:US
Mailing Address - Phone:732-418-1700
Mailing Address - Fax:732-249-9599
Practice Address - Street 1:1527 STATE ROUTE 27
Practice Address - Street 2:SUITE # 1600
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3979
Practice Address - Country:US
Practice Address - Phone:732-418-1700
Practice Address - Fax:732-249-9599
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMAO62160208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJG 24006Medicare UPIN
NJPA849588Medicare ID - Type Unspecified