Provider Demographics
NPI:1932311073
Name:PATEL, CHANDRAKANT (MD)
Entity Type:Individual
Prefix:DR
First Name:CHANDRAKANT
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 1:55 FLINT TER
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07640-1067
Mailing Address - Country:US
Mailing Address - Phone:201-784-1887
Mailing Address - Fax:201-784-1887
Practice Address - Street 1:55 FLINT TER
Practice Address - Street 2:
Practice Address - City:HARRINGTON PARK
Practice Address - State:NJ
Practice Address - Zip Code:07640-1067
Practice Address - Country:US
Practice Address - Phone:201-784-1887
Practice Address - Fax:201-784-1887
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03308400207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0858706Medicaid