| Organization Name: | MITUL R. PATEL M.D. P.C. |
| NPI Number: | 1245521673 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MITUL R. PATEL (PRESIDENT) |
| Mailing Address: | 250 Patchogue Yaphank Rd Suite 7 East Patchogue |
| State: | NY US |
| Postal Code: | 117724800 |
| Phone Number: | 6312890900 |
| Fax Number: | 6317582542 |
| NPI Enumeration Date: | 04/19/2011 |
| NPI Last Update Date: | 04/19/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 203391 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |