MEDICARE: DR. PARAG P PATEL D.M.D.

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	1223G0001X	General Practice Dentistry	48481	NY
2	1223G0001X	General Practice Dentistry	47985	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124018130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PARAG P PATEL D.M.D.

Provider Business Mailing Address
First Line	:	307 E 44TH ST
Second Line	:	#1801
City	:	NYC
State	:	NY
Zip	:	10017-4400
Country	:	US
Telephone Number	:	646-242-8774
Fax Number	:

Provider Business Practice Location Address
First Line	:	770 E TREMONT AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10460-4101
Country	:	US
Telephone Number	:	718-299-1800
Fax Number	:	718-299-1801

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	07/09/2007

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