Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 271931 | NY |
N | 208000000X | Pediatrician | 271931 | NY |
NPI | 1174899652 |
---|---|
Provider Name | Deepa Bhupendra Patel |
First Address | Long Island City, NY 11101-4010 |
Second Address | New Hyde Park, NY 11040-1433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2012 |
Last Update Date | 23/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
390200000X | (05) | NY |