Provider Demographics
NPI:1811974033
Name:PATEL, SUREKHA M (MD,)
Entity type:Individual
Prefix:DR
First Name:SUREKHA
Middle Name:M
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD,
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Mailing Address - Street 1:374 STOCKHOLM ST
Mailing Address - Street 2:SUITE 3-046
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-4006
Mailing Address - Country:US
Mailing Address - Phone:718-486-4278
Mailing Address - Fax:718-963-6396
Practice Address - Street 1:374 STOCKHOLM ST
Practice Address - Street 2:SUITE 3-046
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-4006
Practice Address - Country:US
Practice Address - Phone:718-486-4278
Practice Address - Fax:718-963-6396
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-29
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY159572207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01530038Medicaid
NY9N1541Medicare ID - Type UnspecifiedEMPIRE MEDICARE SERVICES
NY01530038Medicaid
NYE36510Medicare UPIN