Healthcare Provider Details

I. General information

NPI: 1417355959
Provider Name (Legal Business Name): GARGI PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2014
Last Update Date: 02/02/2022
Certification Date: 02/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 GEORGE ST
NEW BRUNSWICK NJ
08901-2020
US

IV. Provider business mailing address

303 GEORGE ST
NEW BRUNSWICK NJ
08901-2020
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-6800
  • Fax: 732-235-6187
Mailing address:
  • Phone: 732-235-6800
  • Fax: 732-235-6187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number25MA10245500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: