Provider Demographics
NPI:1629185764
Name:CHIMAN I PATEL LLC
Entity Type:Organization
Organization Name:CHIMAN I PATEL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIMAN
Authorized Official - Middle Name:I
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-243-0929
Mailing Address - Street 1:144 GOLDEN HILL ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-4117
Mailing Address - Country:US
Mailing Address - Phone:203-243-0929
Mailing Address - Fax:203-331-8288
Practice Address - Street 1:144 GOLDEN HILL ST
Practice Address - Street 2:SUITE 202
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-4117
Practice Address - Country:US
Practice Address - Phone:203-243-0929
Practice Address - Fax:203-331-8288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
010227902CT02OtherBCBS
CT001279026Medicaid
559945000OtherMAGALLAN
7901560OtherAETNA
CT380971OtherMHN
559945000OtherMAGALLAN
E46432Medicare UPIN