Healthcare Provider Details

I. General information

NPI: 1265496962
Provider Name (Legal Business Name): VIRENDRA I PATEL MD MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 FORT WASHINGTON AVENUE, SUITE 532 HERBERT IRVING PAVILION
NEW YORK NY
10032
US

IV. Provider business mailing address

161 FORT WASHINGTON AVENUE, SUITE 532 HERBERT IRVING PAVILION
NEW YORK NY
10032
US

V. Phone/Fax

Practice location:
  • Phone: 212-342-3255
  • Fax: 212-342-3252
Mailing address:
  • Phone: 212-342-3255
  • Fax: 212-342-3252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number25MA11739700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number73713
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number288615
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: