Healthcare Provider Details

I. General information

NPI: 1992022271
Provider Name (Legal Business Name): LEENA NAVIN PATEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2010
Last Update Date: 07/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4209 28TH ST # CN-65
LONG ISLAND CITY NY
11101-4130
US

IV. Provider business mailing address

4209 28TH ST # CN-65
LONG ISLAND CITY NY
11101-4130
US

V. Phone/Fax

Practice location:
  • Phone: 408-887-5562
  • Fax:
Mailing address:
  • Phone: 408-887-5562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA110501
License Number StateCA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: