Healthcare Provider Details

I. General information

NPI: 1316877301
Provider Name (Legal Business Name): NIDHI HITESH PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 N SALINA ST
SYRACUSE NY
13203-1755
US

IV. Provider business mailing address

329 N SALINA ST
SYRACUSE NY
13203-1755
US

V. Phone/Fax

Practice location:
  • Phone: 315-471-1564
  • Fax: 315-474-2531
Mailing address:
  • Phone: 315-471-1564
  • Fax: 315-474-2531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: