Healthcare Provider Details

I. General information

NPI: 1932599222
Provider Name (Legal Business Name): BHARGAV PATEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2015
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25020 HILLSIDE AVE
BELLEROSE NY
11426-2149
US

IV. Provider business mailing address

8314 265TH ST
GLEN OAKS NY
11004-1721
US

V. Phone/Fax

Practice location:
  • Phone: 718-662-6630
  • Fax: 718-682-3842
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number280820
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: