Basic Information
Provider Information
NPI: 1144393950
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: RAJENDRA
MiddleName: K
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12 SPARROW DR
Address2:  
City: PRINCETON JUNCTION
State: NJ
PostalCode: 085502260
CountryCode: US
TelephoneNumber: 6099180045
FaxNumber: 6099180045
Practice Location
Address1: 1945 STATE ROUTE 33
Address2:  
City: NEPTUNE
State: NJ
PostalCode: 077534859
CountryCode: US
TelephoneNumber: 7327764510
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/17/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X25MA05735500NJY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


Home