Provider Demographics
NPI:1326137019
Name:PATEL, ASVINKUMAR C (MD)
Entity Type:Individual
Prefix:DR
First Name:ASVINKUMAR
Middle Name:C
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8222 212TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-1318
Mailing Address - Country:US
Mailing Address - Phone:718-334-2490
Mailing Address - Fax:718-334-5845
Practice Address - Street 1:7901 BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1329
Practice Address - Country:US
Practice Address - Phone:718-334-2490
Practice Address - Fax:718-334-5845
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY159744207RA0401X, 207RX0202X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01021021Medicaid
NY01021021Medicaid
NY6514VXMedicare PIN