MEDICARE: SAURABH C 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	207R00000X	Internal Medicine Physician	MA71391	NJ

General Provider Information

NPI Number	:	1790795227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAURABH C PATEL MD

Provider Business Mailing Address
First Line	:	99 MADISON ST
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07105-2107
Country	:	US
Telephone Number	:	973-344-2929
Fax Number	:	973-344-1239

Provider Business Practice Location Address
First Line	:	99 MADISON ST
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07105-2107
Country	:	US
Telephone Number	:	973-344-2929
Fax Number	:	973-344-1239

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	03/12/2018

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