Provider Demographics
NPI:1528453321
Name:PATEL, NISHA A (MD)
Entity type:Individual
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First Name:NISHA
Middle Name:A
Last Name:PATEL
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Gender:F
Credentials:MD
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Mailing Address - Street 1:331 NEWMAN SPRINGS ROAD
Mailing Address - Street 2:BLDG. 2, SUITE 220
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701
Mailing Address - Country:US
Mailing Address - Phone:732-807-0877
Mailing Address - Fax:201-751-1680
Practice Address - Street 1:725 EAST ADAMS ST
Practice Address - Street 2:5TH FL
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-464-5726
Practice Address - Fax:315-464-2510
Is Sole Proprietor?:No
Enumeration Date:2015-03-30
Last Update Date:2025-04-11
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Provider Licenses
StateLicense IDTaxonomies
NY3104432080P0205X, 2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06726663Medicaid