Healthcare Provider Details

I. General information

NPI: 1245626522
Provider Name (Legal Business Name): HEMAL PATEL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2015
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 RIVER ST APT 246
HACKENSACK NJ
07601-7451
US

IV. Provider business mailing address

100 RIVER ST APT 246
HACKENSACK NJ
07601-7451
US

V. Phone/Fax

Practice location:
  • Phone: 631-372-1312
  • Fax: 307-204-7969
Mailing address:
  • Phone: 631-372-1312
  • Fax: 307-204-7969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number288730
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MB10933500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: