Provider Demographics
NPI:1376757559
Name:PATEL, PARAG P (MD)
Entity Type:Individual
Prefix:DR
First Name:PARAG
Middle Name:P
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:140 CANAL VIEW BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-2808
Mailing Address - Country:US
Mailing Address - Phone:585-338-2700
Mailing Address - Fax:585-242-9663
Practice Address - Street 1:140 CANAL VIEW BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2808
Practice Address - Country:US
Practice Address - Phone:585-338-2700
Practice Address - Fax:585-242-9663
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2023-05-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY258072207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY258072OtherSTATE LICENSE
PO10258072OtherBLUE CHOICE
NY03249245Medicaid
000936046001OtherHEALTH NOW NEW YORK
00936046003OtherHEALTHNOW NY
9479540OtherAETNA
00936046001OtherCOMMUNITY BLUE
NY03249245Medicaid
P00880044Medicare PIN
NY258072OtherSTATE LICENSE