Provider Demographics
NPI:1982594016
Name:PATEL, KEYUR JITENDRAKUMAR
Entity type:Individual
Prefix:
First Name:KEYUR
Middle Name:JITENDRAKUMAR
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ACACIA AVE
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-3664
Mailing Address - Country:US
Mailing Address - Phone:609-453-6461
Mailing Address - Fax:
Practice Address - Street 1:28652 STATE HIGHWAY 23
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:NY
Practice Address - Zip Code:12167-1712
Practice Address - Country:US
Practice Address - Phone:607-652-7521
Practice Address - Fax:607-652-3362
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP136223207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine