Provider Demographics
NPI:1003478520
Name:PATEL, KALINDI (OD)
Entity Type:Individual
Prefix:
First Name:KALINDI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9537 DESTINY USA DRIVE
Mailing Address - Street 2:#723
Mailing Address - City:SYRACUSE
Mailing Address - State:UNITED STATES
Mailing Address - Zip Code:13204
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9537 DESTINY USA DR # 723
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-9501
Practice Address - Country:US
Practice Address - Phone:315-474-8490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-04
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009015152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist