Basic Information
| Provider Information | |||||||||
| NPI: | 1548311319 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | RAHUL | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 63 SHAKER RD | ||||||||
| Address2: | STE 101 | ||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122041030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137747016 | ||||||||
| FaxNumber: | 4137737596 | ||||||||
| Practice Location | |||||||||
| Address1: | 63 SHAKER RD | ||||||||
| Address2: | STE 101 | ||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 122041030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137747016 | ||||||||
| FaxNumber: | 4137737596 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2007 | ||||||||
| LastUpdateDate: | 01/28/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 253704 | MA | N | Other Service Providers | Specialist | 207W00000X | 283796 | NY | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.