Provider Demographics
NPI:1821219262
Name:RASIK L PATEL MDPC
Entity Type:Organization
Organization Name:RASIK L PATEL MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RASIK
Authorized Official - Middle Name:L
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-893-1250
Mailing Address - Street 1:3250 3RD AVE
Mailing Address - Street 2:SUITE #6
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-6743
Mailing Address - Country:US
Mailing Address - Phone:718-893-1250
Mailing Address - Fax:
Practice Address - Street 1:3250 3RD AVE
Practice Address - Street 2:SUITE #6
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-6743
Practice Address - Country:US
Practice Address - Phone:718-893-1250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198627207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02059676Medicaid
NYG37442Medicare UPIN
NY02059676Medicaid