Provider Demographics
NPI:1558492819
Name:ARVIND M. PATEL M.D
Entity type:Organization
Organization Name:ARVIND M. PATEL M.D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARVIND
Authorized Official - Middle Name:MANSUKH
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-721-2200
Mailing Address - Street 1:200 PERRINE RD #203
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-2836
Mailing Address - Country:US
Mailing Address - Phone:732-721-2200
Mailing Address - Fax:732-253-5550
Practice Address - Street 1:200 PERRINE RD #203
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-2836
Practice Address - Country:US
Practice Address - Phone:732-721-2200
Practice Address - Fax:732-253-5550
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARVIND M. PATEL M.D.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-08
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA31780 000208800000X
208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0607306 002OtherCIGNA
NJ1D0743003Medicaid
NJLS079OtherOXFORD
NJ4114893OtherAETNA
NJD06769Medicare UPIN
NJLS079OtherOXFORD