MEDICARE: MAHESH I. 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	173000000X	Legal Medicine	25MA40443	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	25MA40443	OTHER	NJ	MEDICAL LICENSE
2	222749711	OTHER	NJ	TAX ID #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942202841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAHESH I. PATEL MD

Provider Business Mailing Address
First Line	:	3 PINE VALLEY WAY
Second Line	:
City	:	FLORHAM PARK
State	:	NJ
Zip	:	07932-2700
Country	:	US
Telephone Number	:	973-822-7979
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 S ESSEX AVE
Second Line	:
City	:	ORANGE
State	:	NJ
Zip	:	07050-3401
Country	:	US
Telephone Number	:	973-678-6402
Fax Number	:	973-678-6443

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	03/07/2023

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Directions to “ MAHESH I. PATEL MD” Practice Location

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