Provider Demographics
NPI:1316192909
Name:PATEL, PURVA (MPT)
Entity Type:Individual
Prefix:MS
First Name:PURVA
Middle Name:
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 1:11 E 1ST ST
Mailing Address - Street 2:510
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-8996
Mailing Address - Country:US
Mailing Address - Phone:917-797-6877
Mailing Address - Fax:
Practice Address - Street 1:11 E 1ST ST
Practice Address - Street 2:510
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-8996
Practice Address - Country:US
Practice Address - Phone:917-797-6877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018474-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist