| Doctor Name: | DR. MITAL B. PATEL |
| NPI Number: | 1053343871 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.P.M. |
| License Number: | N006053 |
| Business Practice Address: | 20 Hicksville Rd Massapequa, NY - 117585819 |
| Business Phone Number: | 5167440354 |
| Business Fax Number: | 8559591613 |
| Mailing Address: | 20 Hicksville Rd, Suite 2 MASSAPEQUA |
| State: | NY |
| Postal Code: | 117585819 |
| Phone Number: | 2016812654 |
| Fax Number: | 8559591613 |
| NPI Enumeration Date: | 07/06/2006 |
| NPI Last Update Date: | 09/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | N006053 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |