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NPI Code Detail

MEDICARE: MR. VISHAL R PATEL PHYSICIAN ASSISTANT

MEDICARE: MR. VISHAL R PATEL PHYSICIAN ASSISTANT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant25MP00145400NJ
2363A00000XPhysician Assistant

General Provider Information

NPI Number : 1447470711
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VISHAL R PATEL PHYSICIAN ASSISTANT
Provider Business Mailing Address
First Line : 392 SEGUINE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309-3906
Country : US
Telephone Number : 718-226-3823
Fax Number :
Provider Business Practice Location Address
First Line : 392 SEGUINE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309-3906
Country : US
Telephone Number : 718-226-3823
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2007
Last Update Date : 02/08/2022

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