Provider Demographics
NPI:1366915324
Name:PATEL, TRUSHA (NP)
Entity type:Individual
Prefix:
First Name:TRUSHA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BRADFORD RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4001
Mailing Address - Country:US
Mailing Address - Phone:516-574-9030
Mailing Address - Fax:
Practice Address - Street 1:1 DAKOTA DR
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1135
Practice Address - Country:US
Practice Address - Phone:516-622-6020
Practice Address - Fax:516-622-6021
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343899-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY343899-1OtherNYS