Healthcare Provider Details

I. General information

NPI: 1265408843
Provider Name (Legal Business Name): AMAN B PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 09/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 PARKMAN ST WAC-745
BOSTON MA
02114-3117
US

IV. Provider business mailing address

15 PARKMAN ST WAC-745
BOSTON MA
02114-3117
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-3303
  • Fax: 617-726-7501
Mailing address:
  • Phone: 617-726-3303
  • Fax: 617-726-7501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number220272
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number220272
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number220272
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: