Provider Demographics
NPI:1144381831
Name:PATEL, MALTI (MD)
Entity Type:Individual
Prefix:
First Name:MALTI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3980 SHERIDAN DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1727
Mailing Address - Country:US
Mailing Address - Phone:716-250-2000
Mailing Address - Fax:716-250-2040
Practice Address - Street 1:3980 SHERIDAN DR
Practice Address - Street 2:SUITE 200
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1727
Practice Address - Country:US
Practice Address - Phone:716-250-2000
Practice Address - Fax:716-636-1365
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1991072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01566123Medicaid
NY10124070OtherFIDELIS
NY00010134901OtherUNIVERA
NY0507312OtherINDEPENDENT HEALTH
NYPN-N199107OtherWCB
NY000523718002OtherBLUE CROSS & BLUE SHIELD
NY130023058OtherRAILROAD MEDICARE
NY130023058OtherRAILROAD MEDICARE
NY00010134901OtherUNIVERA