MEDICARE: DR. KALPANA PATEL 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	2080P0201X	Pediatric Allergy/Immunology Physician	185565	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	555X51	OTHER	NY	EMPIRE BC.BS
2	5739058	OTHER	NY	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225070303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KALPANA PATEL M.D.

Provider Business Mailing Address
First Line	:	10 S SNEDECOR AVE
Second Line	:
City	:	BAYPORT
State	:	NY
Zip	:	11705-2133
Country	:	US
Telephone Number	:	631-472-0600
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 S SNEDECOR AVE
Second Line	:
City	:	BAYPORT
State	:	NY
Zip	:	11705-2133
Country	:	US
Telephone Number	:	631-472-0600
Fax Number	:

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	11/01/2011

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