Healthcare Provider Details

I. General information

NPI: 1104338045
Provider Name (Legal Business Name): PATEL MEDICAL ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2017
Last Update Date: 11/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2103 KLOCKNER RD
HAMILTON NJ
08690-3403
US

IV. Provider business mailing address

2103 KLOCKNER RD
HAMILTON NJ
08690-3403
US

V. Phone/Fax

Practice location:
  • Phone: 609-586-4739
  • Fax: 609-588-5314
Mailing address:
  • Phone: 609-586-4739
  • Fax: 609-588-5314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: CHANDRESH A PATEL
Title or Position: PHYSICIAN / OWNER
Credential: MD
Phone: 609-586-4739