Provider Demographics
NPI:1457338253
Name:PATEL, JAYANTILAL RAMDAS (MD)
Entity type:Individual
Prefix:MR
First Name:JAYANTILAL
Middle Name:RAMDAS
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7717
Mailing Address - Street 2:STUYVESANT AVENUE
Mailing Address - City:WEST TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-0717
Mailing Address - Country:US
Mailing Address - Phone:609-633-0900
Mailing Address - Fax:609-943-4565
Practice Address - Street 1:STUYVESANT AVENUE
Practice Address - Street 2:ANN KLEIN FORENSIC CENTER
Practice Address - City:WEST TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08648
Practice Address - Country:US
Practice Address - Phone:609-633-0900
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA626272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G72990Medicare UPIN