Provider Demographics
NPI:1538188560
Name:PATEL, KALPANA D (MD)
Entity type:Individual
Prefix:DR
First Name:KALPANA
Middle Name:D
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 1:65 WEHRLE DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14225
Mailing Address - Country:US
Mailing Address - Phone:716-833-2213
Mailing Address - Fax:716-833-2244
Practice Address - Street 1:65 WEHRLE DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14225
Practice Address - Country:US
Practice Address - Phone:716-833-2213
Practice Address - Fax:716-833-2244
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113685207KA0200X, 2080A0000X, 2083P0500X, 2083T0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083T0002XAllopathic & Osteopathic PhysiciansPreventive MedicineMedical Toxicology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY040426000171OtherFIDELIS
NY1207496OtherINDEPENDENT HEALTH
NY00620077Medicaid
NY040426000171OtherFIDELIS