Provider Demographics
NPI:1962765461
Name:PATEL, MANISH B (DO)
Entity type:Individual
Prefix:
First Name:MANISH
Middle Name:B
Last Name:PATEL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:282 ST PAULS AVENUE
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306
Mailing Address - Country:US
Mailing Address - Phone:201-422-2556
Mailing Address - Fax:866-265-3540
Practice Address - Street 1:282 ST PAULS AVENUE
Practice Address - Street 2:FLOOR 1
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306
Practice Address - Country:US
Practice Address - Phone:201-422-2556
Practice Address - Fax:866-265-3540
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-19
Last Update Date:2023-02-22
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB09801400208100000X, 208VP0014X
FLOS13947208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine