Provider Demographics
NPI:1235726423
Name:PATEL, KINJAL H (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:KINJAL
Middle Name:H
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BROADWAY RM 503
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-1981
Mailing Address - Country:US
Mailing Address - Phone:212-952-9355
Mailing Address - Fax:212-952-9356
Practice Address - Street 1:111 BROADWAY RM 503
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-1981
Practice Address - Country:US
Practice Address - Phone:212-952-9355
Practice Address - Fax:212-952-9356
Is Sole Proprietor?:No
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ040253225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist