Healthcare Provider Details

I. General information

NPI: 1730161316
Provider Name (Legal Business Name): AMIT PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 06/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 STONE HARBOR BLVD
CAPE MAY COURT HOUSE NJ
08210-2138
US

IV. Provider business mailing address

2 STONE HARBOR BLVD
CAPE MAY COURT HOUSE NJ
08210-2138
US

V. Phone/Fax

Practice location:
  • Phone: 609-886-2258
  • Fax:
Mailing address:
  • Phone: 609-886-2258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number25MA06843900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number25MA06843900
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number25MA06843900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: