Provider Demographics
NPI:1487996914
Name:PATEL, CHANDRKANT M
Entity type:Individual
Prefix:DR
First Name:CHANDRKANT
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 HEYWARD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-7823
Mailing Address - Country:US
Mailing Address - Phone:718-260-4600
Mailing Address - Fax:718-852-0867
Practice Address - Street 1:14 HEYWARD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-7823
Practice Address - Country:US
Practice Address - Phone:718-260-4600
Practice Address - Fax:718-852-0867
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-22
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY139045208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics