MEDICARE: KALINDI PATEL OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	009015	NY

General Provider Information

NPI Number	:	1003478520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALINDI PATEL OD

Provider Business Mailing Address
First Line	:	9537 DESTINY USA DRIVE
Second Line	:	#723
City	:	SYRACUSE
State	:	UNITED STATES
Zip	:	13204
Country	:	UM
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9537 DESTINY USA DR # 723
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13204-9501
Country	:	US
Telephone Number	:	315-474-8490
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/04/2019
Last Update Date	:	10/03/2019

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Directions to “ KALINDI PATEL OD” Practice Location

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