Healthcare Provider Details

I. General information

NPI: 1114082500
Provider Name (Legal Business Name): BABUBHAI I PATEL PHYSICIAN PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 AMSTERDAM AVE
NEW YORK NY
10032-5013
US

IV. Provider business mailing address

430 ROEDEL PL
PARAMUS NJ
07652-4120
US

V. Phone/Fax

Practice location:
  • Phone: 212-781-2560
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number160703
License Number StateNY

VIII. Authorized Official

Name: BABUBHAI PATEL
Title or Position: SOLE PROPRIETER
Credential:
Phone: 212-781-2560