Provider Demographics
NPI:1952393100
Name:PATEL, AMRITBHAI (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMRITBHAI
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 STONINGTON HTS
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1732
Mailing Address - Country:US
Mailing Address - Phone:914-762-0597
Mailing Address - Fax:718-542-2347
Practice Address - Street 1:1706 WATSON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-5408
Practice Address - Country:US
Practice Address - Phone:718-542-1840
Practice Address - Fax:718-542-2347
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY333151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00288202Medicaid