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NPI 1750677993

NPI 1750677993 : NISH A PATEL MD : NEWTON, NJ

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General NPI Number Information
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    NPI Number           |    1750677993
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    Entity Type          |    Individual 
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    Provider Name        |    NISH A PATEL MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/27/2011
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    Last Update Date     |    04/03/2015
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Provider Practice Location Address
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    Address Line         |    175 HIGH ST 
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    City                 |    NEWTON
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    State                |    NJ
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    Zip                  |    07860-1004
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    Country              |    US
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    Telephone            |    973-383-2121
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3998 FAIR RIDGE DR SUITE 300
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    City                 |    FAIRFAX
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    State                |    VA
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    Zip                  |    22033-2921
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    Country              |    US
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    Telephone            |    703-295-9360
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    Fax                  |    703-766-9725
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207L00000X
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    Taxonomy Name        |    Anesthesiology Physician
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    License Number       |    25MA08920400
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    License Number State |    NJ
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