Provider Demographics
NPI:1205209707
Name:PATEL, DRUTIKA S (PA-C)
Entity Type:Individual
Prefix:
First Name:DRUTIKA
Middle Name:S
Last Name:PATEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:DUNKIRK
Mailing Address - State:NY
Mailing Address - Zip Code:14048-2237
Mailing Address - Country:US
Mailing Address - Phone:716-366-7150
Mailing Address - Fax:716-366-1976
Practice Address - Street 1:322 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:NY
Practice Address - Zip Code:14048-2237
Practice Address - Country:US
Practice Address - Phone:716-366-7150
Practice Address - Fax:716-366-1976
Is Sole Proprietor?:No
Enumeration Date:2015-11-05
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY026600-01363A00000X
FL9108990363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant