MEDICARE: SUNIL 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	207RC0000X	Cardiovascular Disease Physician	MA073729	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255354726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNIL PATEL M.D

Provider Business Mailing Address
First Line	:	PO BOX 178
Second Line	:
City	:	COLONIA
State	:	NJ
Zip	:	07067-0178
Country	:	US
Telephone Number	:	973-275-9500
Fax Number	:	973-275-9501

Provider Business Practice Location Address
First Line	:	2010 SPRINGFIELD AVE
Second Line	:
City	:	MAPLEWOOD
State	:	NJ
Zip	:	07040-3437
Country	:	US
Telephone Number	:	973-275-9500
Fax Number	:	973-275-9501

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	03/04/2014

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