Provider Demographics
NPI:1588688501
Name:PATEL, NARENDRA D (MD)
Entity type:Individual
Prefix:
First Name:NARENDRA
Middle Name:D
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KNOLLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-2411
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:201-934-3341
Practice Address - Street 1:65 N MAPLE AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3233
Practice Address - Country:US
Practice Address - Phone:201-444-8999
Practice Address - Fax:201-934-3341
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2010-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0420502084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1757903Medicaid
F38029Medicare UPIN
NJ536549Medicare ID - Type Unspecified