Basic Information
| Provider Information | |||||||||
| NPI: | 1750451241 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | SONALI | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 MCCLELLAN ST | ||||||||
| Address2: | 2 WEST | ||||||||
| City: | SCHENECTADY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 123041009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5183475400 | ||||||||
| FaxNumber: | 5183475222 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 NOTT ST | ||||||||
| Address2: | |||||||||
| City: | SCHENECTADY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 123082425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5182434000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2006 | ||||||||
| LastUpdateDate: | 05/01/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 003493 | NY | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207Q00000X | 003493 | NY | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 02850402 | 05 | NY | MEDICAID | 6D9231 | 01 | BLUE CROSS | OTHER | P00693837 | 01 | NY | RAILROAD MEDICARE | OTHER | 4153493 | 01 | NY | MVP | OTHER |