Provider Demographics
NPI:1982881124
Name:PATIL, YATIN (MD)
Entity Type:Individual
Prefix:
First Name:YATIN
Middle Name:
Last Name:PATIL
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 1:33 WHITEMARSH DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-9338
Mailing Address - Country:US
Mailing Address - Phone:410-812-0065
Mailing Address - Fax:
Practice Address - Street 1:8117 PRESTON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225
Practice Address - Country:US
Practice Address - Phone:214-666-9619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2018-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD152368207R00000X
VA0101257210207R00000X
PAMD453540207R00000X
NC2015-00589207R00000X
OH35.127464207R00000X
MI4301111086207R00000X
NY291402-1207R00000X
NJ25MA09249300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine