Provider Demographics
NPI:1104038173
Name:PATEL, MADHAVI D (MPT)
Entity Type:Individual
Prefix:MRS
First Name:MADHAVI
Middle Name:D
Last Name:PATEL
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 ROCK RUN ROAD
Mailing Address - Street 2:
Mailing Address - City:HIGHTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08520
Mailing Address - Country:US
Mailing Address - Phone:609-371-0778
Mailing Address - Fax:
Practice Address - Street 1:61 MAPLEWOOD AVE
Practice Address - Street 2:THE ELMS OF CRANBURY
Practice Address - City:CRANBURY
Practice Address - State:NJ
Practice Address - Zip Code:08512
Practice Address - Country:US
Practice Address - Phone:609-395-0641
Practice Address - Fax:609-395-8200
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA008147225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist