Provider Demographics
NPI:1649367129
Name:PATEL, SHILPA ASHOK (MD)
Entity type:Individual
Prefix:
First Name:SHILPA
Middle Name:ASHOK
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 PARIS AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:ROCKLEIGH
Mailing Address - State:NJ
Mailing Address - Zip Code:07647-2600
Mailing Address - Country:US
Mailing Address - Phone:201-564-7377
Mailing Address - Fax:201-564-7379
Practice Address - Street 1:22 PARIS AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:ROCKLEIGH
Practice Address - State:NJ
Practice Address - Zip Code:07647
Practice Address - Country:US
Practice Address - Phone:201-564-7377
Practice Address - Fax:201-564-7379
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07123200208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics