MEDICARE: FALGUNI J. PATEL MSN, APRN, PMHNP-BC

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
1	163WP0808X	Psychiatric/Mental Health Registered Nurse	736068	NY
2	163WP0808X	Psychiatric/Mental Health Registered Nurse	26NR18065500	NJ
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	402295	NY

General Provider Information

NPI Number	:	1730619800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FALGUNI J. PATEL MSN, APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	41-43 CRESCENT STREET
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101
Country	:	US
Telephone Number	:	718-784-2240
Fax Number	:

Provider Business Practice Location Address
First Line	:	4143 CRESCENT ST
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-3805
Country	:	US
Telephone Number	:	718-784-2240
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2017
Last Update Date	:	01/22/2018

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