Basic Information
| Provider Information | |||||||||
| NPI: | 1598883431 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATEL | ||||||||
| FirstName: | PEENAL | ||||||||
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| Credential: | PT, DPT, PT DIRECTOR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 231 BRIGHTON RD | ||||||||
| Address2: | |||||||||
| City: | CLIFTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070121415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9175794898 | ||||||||
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| Practice Location | |||||||||
| Address1: | 150 NORTH ST | ||||||||
| Address2: | |||||||||
| City: | TETERBORO | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076081202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2013939199 | ||||||||
| FaxNumber: | 2013939008 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 225100000X | 40QA011078 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | 025728-1 | NY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.