Provider Demographics
NPI:1760862445
Name:PATEL, ANKUR ASHOK (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANKUR
Middle Name:ASHOK
Last Name:PATEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 COOPERS LN
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-5328
Mailing Address - Country:US
Mailing Address - Phone:860-960-4933
Mailing Address - Fax:
Practice Address - Street 1:168 NEW MILFORD TPKE UNIT 1A
Practice Address - Street 2:
Practice Address - City:NEW PRESTON MARBLE DALE
Practice Address - State:CT
Practice Address - Zip Code:06777-1601
Practice Address - Country:US
Practice Address - Phone:203-417-6979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-08
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT1022213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program