Healthcare Provider Details

I. General information

NPI: 1356322655
Provider Name (Legal Business Name): NIRAV C PATEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 03/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 E 77TH ST 4TH FL
NEW YORK NY
10075-1851
US

IV. Provider business mailing address

130 E 77TH ST 4TH FL
NEW YORK NY
10075-1851
US

V. Phone/Fax

Practice location:
  • Phone: 212-434-3000
  • Fax: 212-434-2837
Mailing address:
  • Phone: 212-434-3000
  • Fax: 212-434-2837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number238916
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: