Healthcare Provider Details

I. General information

NPI: 1033111067
Provider Name (Legal Business Name): MAHESH I. PATEL, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S ESSEX AVE
ORANGE NJ
07050-3401
US

IV. Provider business mailing address

3 PINE VALLEY WAY
FLORHAM PARK NJ
07932-2700
US

V. Phone/Fax

Practice location:
  • Phone: 973-678-6402
  • Fax:
Mailing address:
  • Phone: 973-822-7979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: DR. MAHESH I PATEL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 973-678-6402