Basic Information
Provider Information
NPI: 1356856587
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: PINAL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 416495
Address2:  
City: BOSTON
State: MA
PostalCode: 022417814
CountryCode: US
TelephoneNumber: 6315805200
FaxNumber: 6315805222
Practice Location
Address1: 300 PRINCETON HIGHTSTOWN RD STE 201
Address2:  
City: EAST WINDSOR
State: NJ
PostalCode: 085201411
CountryCode: US
TelephoneNumber: 6094264442
FaxNumber: 6094430910
Other Information
ProviderEnumerationDate: 12/11/2017
LastUpdateDate: 07/15/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/15/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QA01912600NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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