Provider Demographics
NPI:1982806915
Name:PATEL, PRASHANT B (MD)
Entity Type:Individual
Prefix:
First Name:PRASHANT
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:489 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-3143
Mailing Address - Country:US
Mailing Address - Phone:732-356-9950
Mailing Address - Fax:732-356-9959
Practice Address - Street 1:489 UNION AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-3143
Practice Address - Country:US
Practice Address - Phone:732-356-9950
Practice Address - Fax:732-356-9959
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08139100207RS0012X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0135623Medicaid
NJ2872484000OtherBCBS
NJP00426872OtherRAIL ROAD MEDICARE
NJ0135623Medicaid