Provider Demographics
NPI:1831386291
Name:PATEL, VIPUL RATILAL (MD)
Entity type:Individual
Prefix:DR
First Name:VIPUL
Middle Name:RATILAL
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 1:11115 66TH AVE APT 2B
Mailing Address - Street 2:APT. 2B
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1918
Mailing Address - Country:US
Mailing Address - Phone:718-897-0921
Mailing Address - Fax:718-897-0921
Practice Address - Street 1:800 POLY PLACE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209
Practice Address - Country:US
Practice Address - Phone:718-630-6143
Practice Address - Fax:718-630-2822
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program