Provider Demographics
NPI:1225669559
Name:REENAL PATEL MD PC
Entity Type:Organization
Organization Name:REENAL PATEL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:REENAL
Authorized Official - Middle Name:R
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-971-9095
Mailing Address - Street 1:10-17 JACKSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5986
Mailing Address - Country:US
Mailing Address - Phone:718-971-9095
Mailing Address - Fax:718-971-9095
Practice Address - Street 1:10-17 JACKSON AVENUE
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-5986
Practice Address - Country:US
Practice Address - Phone:718-971-9095
Practice Address - Fax:718-971-9095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty