MEDICARE: NEIL HIMANSHU PATEL MD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	208000000X	Pediatrics Physician	MT221155	PA
3	208000000X	Pediatrics Physician	25MA11916800	NJ

General Provider Information

NPI Number	:	1467073353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEIL HIMANSHU PATEL MD

Provider Business Mailing Address
First Line	:	1553 RUTH RD STE 1
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-4075
Country	:	US
Telephone Number	:	732-418-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1553 RUTH RD STE 1
Second Line	:
City	:	NORTH BRUNSWICK
State	:	NJ
Zip	:	08902-4075
Country	:	US
Telephone Number	:	732-418-1700
Fax Number	:

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

Provider Enumeration Date	:	05/01/2020
Last Update Date	:	09/19/2023

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Directions to “ NEIL HIMANSHU PATEL MD” Practice Location

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