Provider Demographics
NPI:1689768988
Name:PATEL, SHARAD K (MD)
Entity Type:Individual
Prefix:
First Name:SHARAD
Middle Name:K
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3184 GRAND CONCOURSE
Mailing Address - Street 2:#2E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-1007
Mailing Address - Country:US
Mailing Address - Phone:718-365-4364
Mailing Address - Fax:718-365-5817
Practice Address - Street 1:3184 GRAND CONCOURSE
Practice Address - Street 2:#2E
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458
Practice Address - Country:US
Practice Address - Phone:718-365-4364
Practice Address - Fax:718-365-5817
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2009-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY174974207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01363735Medicaid
NY01363735Medicaid
E83950Medicare UPIN