MEDICARE: KINJAL PATEL MD PC

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	207R00000X	Internal Medicine Physician	276971	NY

General Provider Information

NPI Number	:	1710381991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINJAL PATEL MD PC

Provider Business Mailing Address
First Line	:	306 GOLD ST
Second Line	:	APT. 35A
City	:	BROOKLYN
State	:	NY
Zip	:	11201-3014
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3420 AVENUE N
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2607
Country	:	US
Telephone Number	:	859-625-4612
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KINJAL PATEL
Credential	:	MD
Telephone Number	:	859-625-4612

Provider Enumeration Date	:	10/16/2014
Last Update Date	:	10/16/2014

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