Provider Demographics
NPI:1669450078
Name:PATEL, JAYANT P (MD)
Entity type:Individual
Prefix:MR
First Name:JAYANT
Middle Name:P
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:78-46 PARSONS BLVD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1922
Mailing Address - Country:US
Mailing Address - Phone:718-380-1733
Mailing Address - Fax:718-380-7959
Practice Address - Street 1:78-46 PARSONS BLVD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11366-1922
Practice Address - Country:US
Practice Address - Phone:718-380-1733
Practice Address - Fax:718-380-7959
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2014-05-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY157572174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00918410Medicaid
NY00918410Medicaid
84290AMedicare Oscar/Certification