Provider Demographics
NPI:1770740714
Name:PATEL, SNEHAL (MD)
Entity type:Individual
Prefix:
First Name:SNEHAL
Middle Name:
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 1:12 LIBERTY SQUARE MALL
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-2400
Mailing Address - Country:US
Mailing Address - Phone:845-942-1001
Mailing Address - Fax:845-942-1431
Practice Address - Street 1:12 LIBERTY SQUARE MALL
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980-2400
Practice Address - Country:US
Practice Address - Phone:845-942-1001
Practice Address - Fax:845-942-1431
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244379174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ130496UMRMedicare PIN
NYOTH000Medicare UPIN
NJ130496W49Medicare PIN
NY64515ES111Medicare PIN