Healthcare Provider Details

I. General information

NPI: 1417044983
Provider Name (Legal Business Name): VILAS J PATIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 BUNNER ST
OSWEGO NY
13126-3357
US

IV. Provider business mailing address

3634 WHISPERING WOODS TER
BALDWINSVILLE NY
13027-8306
US

V. Phone/Fax

Practice location:
  • Phone: 315-343-8162
  • Fax: 315-342-2885
Mailing address:
  • Phone: 315-343-8162
  • Fax: 315-342-2885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number173858
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number173858
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number173858
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number173858
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: