Provider Demographics
NPI:1083803985
Name:DHANSUKH PATEL M.D. PC
Entity Type:Organization
Organization Name:DHANSUKH PATEL M.D. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DHANSUKH
Authorized Official - Middle Name:MANILAL
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-668-6140
Mailing Address - Street 1:11 PARK AVE
Mailing Address - Street 2:SUITE 1K
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-2124
Mailing Address - Country:US
Mailing Address - Phone:914-668-6140
Mailing Address - Fax:914-663-8745
Practice Address - Street 1:11 PARK AVE
Practice Address - Street 2:SUITE 1K
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2124
Practice Address - Country:US
Practice Address - Phone:914-668-6140
Practice Address - Fax:914-663-8745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWDW861OtherMEDICARE GROUP NUMBER
NYWDW861OtherMEDICARE GROUP NUMBER