Healthcare Provider Details

I. General information

NPI: 1093827834
Provider Name (Legal Business Name): KARTIK PATEL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 11/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 ROUTE 46 WEST SUITE 204
MINE HILL NJ
07803-3164
US

IV. Provider business mailing address

195 ROUTE 46 WEST SUITE 204
MINE HILL NJ
07803-3164
US

V. Phone/Fax

Practice location:
  • Phone: 973-573-9900
  • Fax: 973-537-9901
Mailing address:
  • Phone: 973-573-9900
  • Fax: 973-537-9901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberOS013427
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: