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General NPI Number Information
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NPI Number | 1124067962
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Entity Type | Individual
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Provider Name | SURESH M PATEL MD
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 09/23/2019
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Provider Practice Location Address
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Address Line | 20620 LINDEN BLVD
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City | CAMBRIA HEIGHTS
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State | NY
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Zip | 11411-1524
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Country | US
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Telephone | 718-479-6600
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Fax | 718-217-3546
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Provider Business Mailing Address
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Address Line | 55 WATER STREET 2ND FLOOR CRED DEPT
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City | NEW YORK
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State | NY
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Zip | 10041-0004
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Country | US
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Telephone | 646-680-2888
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Fax | 516-542-5556
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 170560
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License Number State | NY
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