Provider Demographics
NPI:1508936121
Name:PATEL, KANU H (MD)
Entity Type:Individual
Prefix:DR
First Name:KANU
Middle Name:H
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 E 15TH ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3532
Mailing Address - Country:US
Mailing Address - Phone:212-673-3737
Mailing Address - Fax:212-979-7369
Practice Address - Street 1:145 E 15TH ST APT 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3532
Practice Address - Country:US
Practice Address - Phone:212-673-3737
Practice Address - Fax:212-979-7369
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165924207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01070295Medicaid
NYB19001Medicare UPIN
NY01070295Medicaid