Healthcare Provider Details

I. General information

NPI: 1063535664
Provider Name (Legal Business Name): PULIN H PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 MERIDIAN RD UNIT 10
EDISON NJ
08820-2848
US

IV. Provider business mailing address

22 MERIDIAN RD UNIT 10
EDISON NJ
08820-2848
US

V. Phone/Fax

Practice location:
  • Phone: 732-243-9808
  • Fax: 732-791-5765
Mailing address:
  • Phone: 732-243-9808
  • Fax: 732-791-5765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberMT 183518
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MA08345000
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: