Provider Demographics
NPI:1467253559
Name:PATEL, SYEDA (DDS)
Entity type:Individual
Prefix:DR
First Name:SYEDA
Middle Name:
Last Name:PATEL
Suffix:
Gender:
Credentials:DDS
Other - Prefix:DR
Other - First Name:SYEDA
Other - Middle Name:
Other - Last Name:MAHBUB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:4 ARLINGTON CT
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-2004
Mailing Address - Country:US
Mailing Address - Phone:203-988-9672
Mailing Address - Fax:
Practice Address - Street 1:101 SOUTH DR STONY BROOK UNIVERSITY
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-0001
Practice Address - Country:US
Practice Address - Phone:203-988-9672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)