Provider Demographics
NPI:1902955222
Name:PATEL, RAKESH (MD)
Entity Type:Individual
Prefix:
First Name:RAKESH
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1191 COLTS LN
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-3965
Mailing Address - Country:US
Mailing Address - Phone:877-634-5864
Mailing Address - Fax:267-239-8005
Practice Address - Street 1:308 FLORAL VALE BOULEVRD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067
Practice Address - Country:US
Practice Address - Phone:877-634-5864
Practice Address - Fax:267-239-8005
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD426697207RC0200X, 207RS0012X
PAMD429967207RP1001X
NJMA08162300207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I49457Medicare UPIN