Healthcare Provider Details

I. General information

NPI: 1548212491
Provider Name (Legal Business Name): NIRMAL V PATEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2735 HENRY HUDSON PKWY
BRONX NY
10463-4745
US

IV. Provider business mailing address

4911 ARLINGTON AVE
BRONX NY
10471-2819
US

V. Phone/Fax

Practice location:
  • Phone: 718-796-1851
  • Fax:
Mailing address:
  • Phone: 917-238-3871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number138825
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: