Provider Demographics
NPI:1124055975
Name:PATEL, BHUPENDRA RAMBHAI (MD)
Entity type:Individual
Prefix:
First Name:BHUPENDRA
Middle Name:RAMBHAI
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 1:3141 45TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11103-1621
Mailing Address - Country:US
Mailing Address - Phone:718-777-3222
Mailing Address - Fax:718-777-0551
Practice Address - Street 1:3141 45TH ST
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11103-1621
Practice Address - Country:US
Practice Address - Phone:718-777-3222
Practice Address - Fax:718-777-0551
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117748207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00218915Medicaid
NYD79319Medicare UPIN
NY00218915Medicaid