MEDICARE: DR. PARAG VISHNU PATEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician	216558-1	NY
2	207RI0011X	Interventional Cardiology Physician	25MA07889200	NJ

General Provider Information

NPI Number	:	1073597308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PARAG VISHNU PATEL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 148
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08754-0148
Country	:	US
Telephone Number	:	732-606-3403
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 HOSPITAL DR STE 12B
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-6434
Country	:	US
Telephone Number	:	732-240-7777
Fax Number	:	732-240-7710

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	02/11/2009

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