Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 25MA08689600 | NJ |
NPI | 1093045197 |
---|---|
Provider Name | Dr. Mitul Suresh Patel |
First Address | Woodcliff Lake, NJ 07677-7855 |
Second Address | Woodcliff Lake, NJ 07677-7855 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2010 |
Last Update Date | 09/07/2014 |