MEDICARE: NIMA PRAFUL 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	2086S0122X	Plastic and Reconstructive Surgery Physician	255682-1	NY
2	208600000X	Surgery Physician	255682-1	NY

General Provider Information

NPI Number	:	1417118845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIMA PRAFUL PATEL M.D.

Provider Business Mailing Address
First Line	:	4878 37TH ST
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-1904
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4878 37TH ST
Second Line	:
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11101-1904
Country	:	US
Telephone Number	:	718-784-0755
Fax Number	:

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

Provider Enumeration Date	:	06/18/2008
Last Update Date	:	03/30/2026

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