Provider Demographics
NPI:1982694857
Name:PATEL, SHEFALI S (MD)
Entity Type:Individual
Prefix:MRS
First Name:SHEFALI
Middle Name:S
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHEFALI
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1804 OAK TREE RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2783
Mailing Address - Country:US
Mailing Address - Phone:732-494-0080
Mailing Address - Fax:732-494-8860
Practice Address - Street 1:1804 OAK TREE RD
Practice Address - Street 2:SUITE 3
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2783
Practice Address - Country:US
Practice Address - Phone:732-494-0080
Practice Address - Fax:732-494-8860
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07052100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H35251Medicare UPIN
9Y9941Medicare ID - Type Unspecified