Provider Demographics
NPI:1285976829
Name:DIPTIKA D PATEL MDPA
Entity type:Organization
Organization Name:DIPTIKA D PATEL MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIPTIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-727-4780
Mailing Address - Street 1:200 PERRINE RD
Mailing Address - Street 2:SUITE 227
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-2842
Mailing Address - Country:US
Mailing Address - Phone:732-727-4780
Mailing Address - Fax:732-727-1989
Practice Address - Street 1:200 PERRINE RD
Practice Address - Street 2:SUITE 227
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-2842
Practice Address - Country:US
Practice Address - Phone:732-727-4780
Practice Address - Fax:732-727-1989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty