Basic Information
Provider Information
NPI: 1952048910
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATEL
FirstName: VINITA
MiddleName:  
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Credential:  
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Mailing Information
Address1: 1311 MAMARONECK AVE STE 140
Address2:  
City: WHITE PLAINS
State: NY
PostalCode: 106055224
CountryCode: US
TelephoneNumber: 9142944050
FaxNumber:  
Practice Location
Address1: 1940 S WEST BLVD BLDG A
Address2:  
City: VINELAND
State: NJ
PostalCode: 083607024
CountryCode: US
TelephoneNumber: 8566909977
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/19/2022
LastUpdateDate: 05/19/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 05/19/2022

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

No ID Information.


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