Provider Demographics
NPI:1730202979
Name:PATEL, KATIE (MD)
Entity type:Individual
Prefix:DR
First Name:KATIE
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:284 ASHAROKEN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-1160
Mailing Address - Country:US
Mailing Address - Phone:631-262-0627
Mailing Address - Fax:631-262-0627
Practice Address - Street 1:284 ASHAROKEN AVE
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-1160
Practice Address - Country:US
Practice Address - Phone:631-262-0627
Practice Address - Fax:631-262-0627
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY123213207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology