Provider Demographics
NPI:1164568713
Name:PATEL, SURESH R (MD)
Entity Type:Individual
Prefix:DR
First Name:SURESH
Middle Name:R
Last Name:PATEL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:8131 266TH ST
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1538
Mailing Address - Country:US
Mailing Address - Phone:718-264-3954
Mailing Address - Fax:718-264-3951
Practice Address - Street 1:8045 WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-2193
Practice Address - Country:US
Practice Address - Phone:718-264-3954
Practice Address - Fax:718-264-3951
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYNY1400832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE40777Medicare UPIN