Provider Demographics
NPI:1265853154
Name:PATEL, ROSHANI
Entity type:Individual
Prefix:DR
First Name:ROSHANI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 TERRYVILLE AVE, UNIT 2
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-4078
Mailing Address - Country:US
Mailing Address - Phone:860-261-5217
Mailing Address - Fax:860-261-5525
Practice Address - Street 1:665 TERRYVILLE AVE, UNIT 2
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4078
Practice Address - Country:US
Practice Address - Phone:860-261-5217
Practice Address - Fax:860-261-5525
Is Sole Proprietor?:No
Enumeration Date:2013-12-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT55016208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist