MEDICARE: MAYANK PATEL MD

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	207P00000X	Emergency Medicine Physician	203392	NY
2	208000000X	Pediatrics Physician	203392	NY

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	:	1336191220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAYANK PATEL MD

Provider Business Mailing Address
First Line	:	25602 HILLSIDE AVE
Second Line	:	1ST FLOOR
City	:	FLORAL PARK
State	:	NY
Zip	:	11004-1618
Country	:	US
Telephone Number	:	718-343-3535
Fax Number	:	718-343-7272

Provider Business Practice Location Address
First Line	:	25602 HILLSIDE AVE
Second Line	:	1ST FLOOR
City	:	FLORAL PARK
State	:	NY
Zip	:	11004-1618
Country	:	US
Telephone Number	:	718-343-3535
Fax Number	:	718-343-7272

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

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	01/27/2012

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Directions to “ MAYANK PATEL MD” Practice Location

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