Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 25MA0966400 | NJ |
N | 111NI0900X | Internist | 25MA0966400 | NJ |
N | 207RC0000X | Internist - Cardiovascular Disease | 25MA0966400 | NJ |
Y | 207RI0011X | Interventional Cardiology | 25MA0966400 | NJ |
NPI | 1114326162 |
---|---|
Provider Name | Chirag D Patel |
First Address | South Orange, NJ 07079-2698 |
Second Address | South Orange, NJ 07079-2698 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2014 |
Last Update Date | 21/11/2019 |