Healthcare Provider Details

I. General information

NPI: 1932577194
Provider Name (Legal Business Name): MILAN PATEL PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2015
Last Update Date: 07/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 JERICHO TPKE
SYOSSET NY
11791-4515
US

IV. Provider business mailing address

221 JERICHO TPKE
SYOSSET NY
11791-4515
US

V. Phone/Fax

Practice location:
  • Phone: 646-431-1566
  • Fax:
Mailing address:
  • Phone: 516-496-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: