Provider Demographics
NPI:1720167554
Name:HARSHIT M. PATEL PHYSICIAN, MD, PC
Entity Type:Organization
Organization Name:HARSHIT M. PATEL PHYSICIAN, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARSHIT
Authorized Official - Middle Name:M
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-822-6655
Mailing Address - Street 1:120 BETHPAGE RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-1515
Mailing Address - Country:US
Mailing Address - Phone:516-822-6655
Mailing Address - Fax:516-214-8072
Practice Address - Street 1:120 BETHPAGE RD
Practice Address - Street 2:SUITE 310
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-1515
Practice Address - Country:US
Practice Address - Phone:516-822-6655
Practice Address - Fax:516-214-8072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220306207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02315557Medicaid
NY02315557Medicaid
NYWCP761Medicare PIN