Provider Demographics
NPI:1386198786
Name:PATEL, PRITESHKUMAR (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:PRITESHKUMAR
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:MR
Other - First Name:PRITESH
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:470 TUCKAHOE RD
Mailing Address - Street 2:APT 2B
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-5710
Mailing Address - Country:US
Mailing Address - Phone:972-201-4303
Mailing Address - Fax:
Practice Address - Street 1:470 TUCKAHOE RD
Practice Address - Street 2:APT 2B
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-5710
Practice Address - Country:US
Practice Address - Phone:972-201-4303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032786225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist