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General NPI Number Information
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NPI Number | 1386874352
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Entity Type | Organization
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Legal Business Name | GUARDIAN MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 07/23/2009
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Last Update Date | 07/23/2009
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Provider Practice Location Address
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Address Line | 4 PRINCESS RD SUITE 204
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2322
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Country | US
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Telephone | 609-662-1801
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Fax |
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Provider Business Mailing Address
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Address Line | 4 PRINCESS RD SUITE 201
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2322
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | RAJIV PATEL
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Credential | M.D.
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Telephone | 609-662-1801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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