Provider Demographics
NPI:1811549355
Name:PATEL, PAYAL (FNP)
Entity Type:Individual
Prefix:
First Name:PAYAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 DEWEY AVE
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1729
Mailing Address - Country:US
Mailing Address - Phone:917-224-6677
Mailing Address - Fax:
Practice Address - Street 1:129 JACKSON ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-2412
Practice Address - Country:US
Practice Address - Phone:917-224-6677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-15
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2329847363LF0000X, 163W00000X
NY669935163W00000X
CT157045163W00000X
CT8012363LF0000X
NY343895363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse