Provider Demographics
NPI:1003918525
Name:PATEL, NARENDRA N (MD)
Entity Type:Individual
Prefix:
First Name:NARENDRA
Middle Name:N
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 BRYSON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-1922
Mailing Address - Country:US
Mailing Address - Phone:718-370-7439
Mailing Address - Fax:908-322-4567
Practice Address - Street 1:201 BRYSON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-1922
Practice Address - Country:US
Practice Address - Phone:718-370-7439
Practice Address - Fax:908-322-4567
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1412462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00720796Medicaid
NY141246OtherHIP OF NY
NYNPC13233OtherELDERPLAN OF NY
109791OtherMANAGED HEALTH NETWORK
NY147056OtherVALUE OPTION
NY33874OtherCIGNA
OS285OtherOXFORD
NY141246OtherHIP OF NY
75A861Medicare ID - Type Unspecified
WAW681Medicare ID - Type Unspecified