Provider Demographics
NPI:1578598843
Name:PATEL, REKHA S (MD)
Entity Type:Individual
Prefix:
First Name:REKHA
Middle Name:S
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:415 HOOPER RD
Mailing Address - Street 2:
Mailing Address - City:ENDWELL
Mailing Address - State:NY
Mailing Address - Zip Code:13760-3698
Mailing Address - Country:US
Mailing Address - Phone:607-754-3863
Mailing Address - Fax:607-754-5697
Practice Address - Street 1:415 HOOPER ROAD
Practice Address - Street 2:ENDWELL FAMILY PHYSICIANS LLP
Practice Address - City:ENDWELL
Practice Address - State:NY
Practice Address - Zip Code:13760-3698
Practice Address - Country:US
Practice Address - Phone:607-754-3863
Practice Address - Fax:607-754-5697
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY209630207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
21306OtherEXCELLUS
88375OtherMVP
NY02143539Medicaid
21306OtherHMO BLUE
515662OtherAETNA HMO
10047171OtherCDPHP
21306OtherBS CNY
5998134OtherGHI
21306OtherBLUEPOINT
21306OtherEMPIRE BS
515662OtherAETNA
58143OtherGHI HMO
88375OtherMVP SELECT
NY0063723OtherCHAMPUS
21306OtherEMPIRE BS
5998134OtherGHI