Individual
KISHI M PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
7206 NORTHERN BLVD, JACKSON HEIGHTS, NY 11372-1049
(866) 670-6824
Mailing address
423 ACORN DR, PARAMUS, NJ 07652-4144
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
316127
NY
390200000X
Student in an Organized Health Care Education/Training Program
OT019007
PA
Other
Enumeration date
03/25/2019
Last updated
05/18/2023
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