Provider Demographics
NPI:1770571168
Name:PATEL, ARVIND M (MD)
Entity type:Individual
Prefix:MR
First Name:ARVIND
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:315 WEST MAIN STREET STE A
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728
Mailing Address - Country:US
Mailing Address - Phone:732-431-3373
Mailing Address - Fax:732-303-0172
Practice Address - Street 1:315 WEST MAIN STREET STE A
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728
Practice Address - Country:US
Practice Address - Phone:732-431-3373
Practice Address - Fax:732-303-0172
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA05759600208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6015506Medicaid
NJG19652Medicare UPIN