Provider Demographics
NPI:1932360617
Name:PATEL, VIMAL D (MD)
Entity Type:Individual
Prefix:DR
First Name:VIMAL
Middle Name:D
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 1:16 YARDLEY ST
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1919
Mailing Address - Country:US
Mailing Address - Phone:732-259-9562
Mailing Address - Fax:
Practice Address - Street 1:200 LITTLE ALBANY STREET
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1914
Practice Address - Country:US
Practice Address - Phone:732-235-2761
Practice Address - Fax:732-235-8777
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08416200207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0168742Medicaid
NJ128383XPFMedicare PIN
NJ128383AHEMedicare PIN