Provider Demographics
NPI:1316980527
Name:PATEL, JAYESHKUMAR K (MD)
Entity type:Individual
Prefix:DR
First Name:JAYESHKUMAR
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:143 CHANCELLOR DR
Mailing Address - Street 2:
Mailing Address - City:DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-5158
Mailing Address - Country:US
Mailing Address - Phone:856-264-0351
Mailing Address - Fax:609-463-4991
Practice Address - Street 1:2 STONE HARBOR BLVD
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2138
Practice Address - Country:US
Practice Address - Phone:609-463-2803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07798800207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
60039116OtherHORIZON NJ HEALTH
P3883764OtherOXFORD
3K8110OtherHEALTHNET
010046337OtherAMERICHOICE
NJP00738363OtherRR MEDICARE
60039111OtherHORIZON NJ HEALTH
60039116OtherHORIZON NJ HEALTH
60039111OtherHORIZON NJ HEALTH
NJ087905ZDQ0Medicare PIN