Provider Demographics
NPI:1487724795
Name:PATEL, RAMAN R (MD)
Entity type:Individual
Prefix:
First Name:RAMAN
Middle Name:R
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1707 ABBOTT RD
Mailing Address - Street 2:
Mailing Address - City:LACKAWANNA
Mailing Address - State:NY
Mailing Address - Zip Code:14218-2940
Mailing Address - Country:US
Mailing Address - Phone:716-822-3831
Mailing Address - Fax:716-822-3832
Practice Address - Street 1:1707 ABBOTT RD
Practice Address - Street 2:
Practice Address - City:LACKAWANNA
Practice Address - State:NY
Practice Address - Zip Code:14218-2940
Practice Address - Country:US
Practice Address - Phone:716-822-3831
Practice Address - Fax:716-822-3832
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY127633208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics