Provider Demographics
NPI:1649261066
Name:PATEL, KARTIK (MD)
Entity type:Individual
Prefix:
First Name:KARTIK
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:45 WEBSTER COMMONS BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-3813
Mailing Address - Country:US
Mailing Address - Phone:585-872-0650
Mailing Address - Fax:585-872-2474
Practice Address - Street 1:45 WEBSTER COMMONS BLVD
Practice Address - Street 2:STE 200
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-3813
Practice Address - Country:US
Practice Address - Phone:585-872-0650
Practice Address - Fax:585-872-2474
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2036041207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01669974Medicaid
G31478Medicare UPIN
NY01669974Medicaid