Provider Demographics
NPI:1306232293
Name:PATEL, SHILA
Entity Type:Individual
Prefix:
First Name:SHILA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3224
Mailing Address - Country:US
Mailing Address - Phone:203-498-5980
Mailing Address - Fax:203-498-5999
Practice Address - Street 1:680 S MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-3181
Practice Address - Country:US
Practice Address - Phone:203-272-3120
Practice Address - Fax:203-272-3151
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10275225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist