Provider Demographics
NPI:1619913894
Name:PATEL, SMITA (MD)
Entity Type:Individual
Prefix:DR
First Name:SMITA
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 1:92 MONTVALE AVE., SMITA PATEL M.D. & ASSO.
Mailing Address - Street 2:SUITE 2200
Mailing Address - City:STONEHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02180-3647
Mailing Address - Country:US
Mailing Address - Phone:781-438-4300
Mailing Address - Fax:781-279-2078
Practice Address - Street 1:92 MONTVALE AVE
Practice Address - Street 2:SUITE 2200 , SMITA PATEL, M.D. AND ASSOC.
Practice Address - City:STONEHAM
Practice Address - State:MA
Practice Address - Zip Code:02180-3647
Practice Address - Country:US
Practice Address - Phone:781-438-4300
Practice Address - Fax:781-279-2078
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA528612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJO6153Medicare ID - Type Unspecified