Healthcare Provider Details

I. General information

NPI: 1073500047
Provider Name (Legal Business Name): SARIT M PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 08/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LAKE ST GROVE HILL MEDICAL CENTER
NEW BRITAIN CT
06052-1396
US

IV. Provider business mailing address

2110 SILAS DEANE HWY
ROCKY HILL CT
06067-2313
US

V. Phone/Fax

Practice location:
  • Phone: 860-826-4460
  • Fax: 860-826-4436
Mailing address:
  • Phone: 860-826-4460
  • Fax: 860-826-4436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number043082
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number043082
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number238678
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: