Healthcare Provider Details

I. General information

NPI: 1588125587
Provider Name (Legal Business Name): PRATEEK SINGH BAGHEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2019
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 ALEXANDER RD STE 202
PRINCETON NJ
08540-6345
US

IV. Provider business mailing address

100 E 77TH ST
NEW YORK NY
10075-1850
US

V. Phone/Fax

Practice location:
  • Phone: 609-921-7456
  • Fax:
Mailing address:
  • Phone: 212-434-0123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA12132000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: