Provider Demographics
NPI:1629202981
Name:PATEL, KIRAN V (MD, DABA, DAPM)
Entity Type:Individual
Prefix:MS
First Name:KIRAN
Middle Name:V
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD, DABA, DAPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 COLUMBUS CIRCLE 10TH FL
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019
Mailing Address - Country:US
Mailing Address - Phone:212-434-6645
Mailing Address - Fax:212-265-9718
Practice Address - Street 1:5 COLUMBUS CIRCLE 10TH FL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019
Practice Address - Country:US
Practice Address - Phone:212-434-6645
Practice Address - Fax:212-265-9718
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249162207L00000X, 207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400054136Medicare PIN