MEDICARE: PATNAIK INTERNAL MEDICINE LLC

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1346131356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATNAIK INTERNAL MEDICINE LLC

Provider Business Mailing Address
First Line	:	100 STARBOARD WAY
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-6116
Country	:	US
Telephone Number	:	856-313-6071
Fax Number	:

Provider Business Practice Location Address
First Line	:	2119 KLOCKNER RD
Second Line	:
City	:	HAMILTON
State	:	NJ
Zip	:	08690-3417
Country	:	US
Telephone Number	:	609-249-4200
Fax Number	:	855-538-9804

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ASIT PATNAIK
Credential	:	MD
Telephone Number	:	856-313-6071

Provider Enumeration Date	:	07/09/2025
Last Update Date	:	11/16/2025

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