Healthcare Provider Details

I. General information

NPI: 1932414042
Provider Name (Legal Business Name): MARUTI MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2010
Last Update Date: 08/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

483 RIVER AVE
LAKEWOOD NJ
08701-4720
US

IV. Provider business mailing address

483 RIVER AVE
LAKEWOOD NJ
08701-4720
US

V. Phone/Fax

Practice location:
  • Phone: 732-364-6001
  • Fax: 732-364-3531
Mailing address:
  • Phone: 732-364-6001
  • Fax: 732-364-3531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number25MA08271300
License Number StateNJ

VIII. Authorized Official

Name: DR. KALPESHKUMAR P PATEL
Title or Position: MEMBER
Credential: M.D.
Phone: 732-364-6001