Provider Demographics
NPI:1457536377
Name:PATEL, NICK N (DO)
Entity Type:Individual
Prefix:DR
First Name:NICK
Middle Name:N
Last Name:PATEL
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Gender:M
Credentials:DO
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Mailing Address - Street 1:45 RESEARCH WAY STE 105
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-6401
Mailing Address - Country:US
Mailing Address - Phone:631-675-2624
Mailing Address - Fax:631-675-2125
Practice Address - Street 1:70 N COUNTRY RD STE 101
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-2161
Practice Address - Country:US
Practice Address - Phone:631-473-0037
Practice Address - Fax:631-473-0228
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2022-04-29
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Provider Licenses
StateLicense IDTaxonomies
NY246771207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine