Provider Demographics
NPI:1104377720
Name:PATEL, VAISHALI (PT)
Entity Type:Individual
Prefix:
First Name:VAISHALI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3911 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-2147
Mailing Address - Country:US
Mailing Address - Phone:302-764-8192
Mailing Address - Fax:302-764-8185
Practice Address - Street 1:9936 CHAPEL HILL RD
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-9397
Practice Address - Country:US
Practice Address - Phone:919-296-0895
Practice Address - Fax:919-657-9149
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0003562225100000X
NCP21919225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist