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General NPI Number Information
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NPI Number | 1689856403
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Entity Type | Organization
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Legal Business Name | SUDHA PATEL MD PLLC
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Dates
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Enumeration Date | 12/04/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1835 BAY RIDGE PARKWAY
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City | BROOKLYN
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State | NY
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Zip | 11204-5706
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Country | US
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Telephone | 718-236-6025
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Fax | 718-236-6391
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Provider Business Mailing Address
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Address Line | 1835 BAY RIDGE PKWY
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City | BROOKLYN
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State | NY
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Zip | 11204-5706
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Country | US
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Telephone | 718-236-6025
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Fax | 718-236-6391
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUDHA P. PATEL
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Credential | M.D.
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Telephone | 718-236-6025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 129033
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License Number State | NY
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