Provider Demographics
NPI:1225070303
Name:PATEL, KALPANA (MD)
Entity Type:Individual
Prefix:DR
First Name:KALPANA
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 1:10 S SNEDECOR AVE
Mailing Address - Street 2:
Mailing Address - City:BAYPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11705-2133
Mailing Address - Country:US
Mailing Address - Phone:631-472-0600
Mailing Address - Fax:
Practice Address - Street 1:10 S SNEDECOR AVE
Practice Address - Street 2:
Practice Address - City:BAYPORT
Practice Address - State:NY
Practice Address - Zip Code:11705-2133
Practice Address - Country:US
Practice Address - Phone:631-472-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1855652080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY555X51OtherEMPIRE BC.BS
NY5739058OtherAETNA
NY01245638Medicaid
NY88F531Medicare PIN
NY555X51OtherEMPIRE BC.BS