Healthcare Provider Details

I. General information

NPI: 1639153752
Provider Name (Legal Business Name): DHANSUKHLAL MANILAL PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DHANSUKH MANILAL PATEL M.D.

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 PARK AVE SUITE 1K
MOUNT VERNON NY
10550-2124
US

IV. Provider business mailing address

11 PARK AVE SUITE 1K
MOUNT VERNON NY
10550-2124
US

V. Phone/Fax

Practice location:
  • Phone: 914-668-6140
  • Fax: 914-663-8745
Mailing address:
  • Phone: 914-668-6140
  • Fax: 914-663-8745

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number146194
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: