Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 199928 | NY |
NPI | 1003914789 |
---|---|
Provider Name | Dr. Chetankumar Patel |
First Address | Melville, NY 11747-4230 |
Second Address | Jamaica, NY 11418-2897 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01647016 | (05) | NY |
G27116 | (02) | NY |