Healthcare Provider Details

I. General information

NPI: 1083289599
Provider Name (Legal Business Name): SAMARTH PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5290 MILITARY RD STE 8
LEWISTON NY
14092-1953
US

IV. Provider business mailing address

144 GENESEE ST
BUFFALO NY
14203-1560
US

V. Phone/Fax

Practice location:
  • Phone: 716-298-3000
  • Fax:
Mailing address:
  • Phone: 716-601-3723
  • Fax: 716-601-3620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number331153
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: