Provider Demographics
NPI:1538185509
Name:PATEL, CHIMAN ISHWERBHAI (MD)
Entity type:Individual
Prefix:
First Name:CHIMAN
Middle Name:ISHWERBHAI
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 1:36 OLD BETHEL RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06470-1407
Mailing Address - Country:US
Mailing Address - Phone:203-512-7884
Mailing Address - Fax:
Practice Address - Street 1:1071 STONELEIGH AVE
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2400
Practice Address - Country:US
Practice Address - Phone:845-225-3553
Practice Address - Fax:845-225-3591
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0279022084P0800X
NY1736762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT297499OtherMHN
CT486769OtherVALUE OPTIONS
CT001279026Medicaid
CTP2949831OtherOXFORD
CT001279026Medicaid
CT297499OtherMHN