MEDICARE: NARENDRA D 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	2084P0800X	Psychiatry Physician	042050	NJ
2	2084P0805X	Geriatric Psychiatry Physician	042050	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	:	1588688501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NARENDRA D PATEL M.D.

Provider Business Mailing Address
First Line	:	100 KNOLLWOOD RD
Second Line	:
City	:	UPPER SADDLE RIVER
State	:	NJ
Zip	:	07458-2411
Country	:	US
Telephone Number	:
Fax Number	:	201-934-3341

Provider Business Practice Location Address
First Line	:	65 N MAPLE AVE
Second Line	:	SUITE 104
City	:	RIDGEWOOD
State	:	NJ
Zip	:	07450-3233
Country	:	US
Telephone Number	:	201-444-8999
Fax Number	:	201-934-3341

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/03/2010

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Directions to “ NARENDRA D PATEL M.D.” Practice Location

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