Provider Demographics
NPI:1992022271
Name:PATEL, LEENA NAVIN (MD)
Entity Type:Individual
Prefix:
First Name:LEENA
Middle Name:NAVIN
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4209 28TH ST # CN-65
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4130
Mailing Address - Country:US
Mailing Address - Phone:408-887-5562
Mailing Address - Fax:
Practice Address - Street 1:4209 28TH ST # CN-65
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-4130
Practice Address - Country:US
Practice Address - Phone:408-887-5562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110501208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics