Basic Information
| Provider Information | |||||||||
| NPI: | 1407110828 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | YOGESH | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1925 PACIFIC AVE | ||||||||
| Address2: | |||||||||
| City: | ATLANTIC CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 084016713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094418146 | ||||||||
| FaxNumber: | 6094418002 | ||||||||
| Practice Location | |||||||||
| Address1: | 1925 PACIFIC AVE | ||||||||
| Address2: | |||||||||
| City: | ATLANTIC CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094418146 | ||||||||
| FaxNumber: | 6094418002 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2012 | ||||||||
| LastUpdateDate: | 10/21/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 72401 | GA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD.34882 | AL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MT201869 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 25MA10020100 | NJ | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.