MEDICARE: CHAULA P. 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	207R00000X	Internal Medicine Physician	203633	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	:	1861570558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAULA P. PATEL MD

Provider Business Mailing Address
First Line	:	30 MCGEORY AVE
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10708-6615
Country	:	US
Telephone Number	:	718-733-6369
Fax Number	:	718-294-4365

Provider Business Practice Location Address
First Line	:	1560 GRAND CONCOURSE
Second Line	:	SUITE 102
City	:	BRONX
State	:	NY
Zip	:	10457-8402
Country	:	US
Telephone Number	:	718-733-6369
Fax Number	:	718-294-4365

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	04/28/2008

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