Provider Demographics
NPI:1598109522
Name:PATEL, KRIYA (MD)
Entity Type:Individual
Prefix:DR
First Name:KRIYA
Middle Name:
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 1:700 S TELEPHONE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-2538
Mailing Address - Country:US
Mailing Address - Phone:405-912-3120
Mailing Address - Fax:405-912-3139
Practice Address - Street 1:700 S TELEPHONE RD STE 201
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-2538
Practice Address - Country:US
Practice Address - Phone:405-912-3120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-21
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09850100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400153816Medicare PIN