Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | N006053 | NY |
NPI | 1053343871 |
---|---|
Provider Name | Dr. Mital B. Patel |
First Address | Massapequa, NY 11758-5819 |
Second Address | Massapequa, NY 11758-5819 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 28/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02669029 | (05) | NY |
06968 | (02) | NY |
V03425 | (02) | NY |