=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164334660
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PIYUSH PATEL
-----------------------------------------------------
Gender |
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2026
-----------------------------------------------------
Last Update Date | 09/19/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 N BEVERWYCK RD APT 3
-----------------------------------------------------
City | LAKE HIAWATHA
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07034-2222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-508-3736
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 101 N BEVERWYCK RD APT 3
-----------------------------------------------------
City | LAKE HIAWATHA
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07034-2222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WC0200X
-----------------------------------------------------
Taxonomy Name | Critical Care Medicine Registered Nurse
-----------------------------------------------------
License Number | 26NR24980400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------