Provider Demographics
NPI:1528139961
Name:PATEL, DINESH G (MD)
Entity type:Individual
Prefix:DR
First Name:DINESH
Middle Name:G
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:117-119 ROOSEVELT AVENUE
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-1331
Mailing Address - Country:US
Mailing Address - Phone:908-756-6870
Mailing Address - Fax:908-756-5566
Practice Address - Street 1:117-119 ROOSEVELT AVENUE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-1331
Practice Address - Country:US
Practice Address - Phone:908-756-6870
Practice Address - Fax:908-756-5566
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA057753002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5616603Medicaid
NJ734134BFOMedicare ID - Type Unspecified
NJ5616603Medicaid