Provider Demographics
NPI:1316376551
Name:NOBLE PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:NOBLE PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAKESHKUMAR
Authorized Official - Middle Name:P
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MS, OCS, FMS
Authorized Official - Phone:347-419-3233
Mailing Address - Street 1:3019 LASALLE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-6021
Mailing Address - Country:US
Mailing Address - Phone:347-419-3233
Mailing Address - Fax:914-992-8240
Practice Address - Street 1:444 E BOSTON POST RD
Practice Address - Street 2:SUITE # 104
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-3708
Practice Address - Country:US
Practice Address - Phone:347-419-3233
Practice Address - Fax:914-992-8240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028089-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy