Provider Demographics
NPI:1700879319
Name:PATEL, VINODBHAI RAMANBHAI (MD)
Entity Type:Individual
Prefix:
First Name:VINODBHAI
Middle Name:RAMANBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GOLD CUP DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1315 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14208
Practice Address - Country:US
Practice Address - Phone:716-885-4830
Practice Address - Fax:716-332-4247
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229883207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02082497Medicaid
NY02082497Medicaid
H21699Medicare UPIN