Healthcare Provider Details

I. General information

NPI: 1215045562
Provider Name (Legal Business Name): NATVERLAL M PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 CONVERY BLVD
PERTH AMBOY NJ
08861-2525
US

IV. Provider business mailing address

751 CONVERY BLVD
PERTH AMBOY NJ
08861-2525
US

V. Phone/Fax

Practice location:
  • Phone: 732-442-6995
  • Fax: 732-442-6994
Mailing address:
  • Phone: 732-442-6995
  • Fax: 732-442-6994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMA29314
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: