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NPI Code Detail

MEDICARE: DR. PRAVIN P PATEL M.D.,

MEDICARE: DR. PRAVIN P 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
1207R00000XInternal Medicine Physician143535NY

Other Identifiers

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

General Provider Information

NPI Number : 1679557292
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PRAVIN P PATEL M.D.,
Provider Business Mailing Address
First Line : 67 STEPHENS DR
Second Line :
City : TARRYTOWN
State : NY
Zip : 10591-6110
Country : US
Telephone Number : 914-316-2851
Fax Number :
Provider Business Practice Location Address
First Line : 3455 BOSTON RD
Second Line :
City : BRONX
State : NY
Zip : 10469-2508
Country : US
Telephone Number : 718-798-2236
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2005
Last Update Date : 05/03/2017

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