Provider Demographics
NPI:1760158067
Name:PATEL, NIKITA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NIKITA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 E 63RD ST APT 1118
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7457
Mailing Address - Country:US
Mailing Address - Phone:615-972-8922
Mailing Address - Fax:
Practice Address - Street 1:155 W 72ND ST RM 505
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3250
Practice Address - Country:US
Practice Address - Phone:917-497-2760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111483-01103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist