Provider Demographics
NPI:1932178357
Name:PATEL, HEMANTKUMAR G (MD)
Entity type:Individual
Prefix:DR
First Name:HEMANTKUMAR
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:PO BOX 290
Mailing Address - Street 2:
Mailing Address - City:VAUXHALL
Mailing Address - State:NJ
Mailing Address - Zip Code:07088-0290
Mailing Address - Country:US
Mailing Address - Phone:973-373-7700
Mailing Address - Fax:973-373-8177
Practice Address - Street 1:646 SANFORD AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07106-3036
Practice Address - Country:US
Practice Address - Phone:973-373-7700
Practice Address - Fax:973-373-8177
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA043021207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3830501Medicaid
NJE13126Medicare UPIN
NJ3830501Medicaid