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General NPI Number Information
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NPI Number | 1841797669
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Entity Type | Organization
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Legal Business Name | RAJ H PATEL MD PA
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 04/09/2018
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Provider Practice Location Address
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Address Line | 701 STUYVESANT AVE
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City | IRVINGTON
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State | NJ
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Zip | 07111-1823
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Country | US
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Telephone | 973-372-1828
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 290
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City | VAUXHALL
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State | NJ
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Zip | 07088-0290
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Country | US
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Telephone | 973-372-1828
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Fax |
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Authorized Official
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Title or Position | MANGER
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Name | SANGITA PATEL
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Credential |
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Telephone | 732-902-2801
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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 | 25MA10303200
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License Number State | NJ
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