Provider Demographics
NPI:1407169295
Name:PATEL, BHAVYANG BABULAL (PT)
Entity Type:Individual
Prefix:
First Name:BHAVYANG
Middle Name:BABULAL
Last Name:PATEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ROMAINE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-5604
Mailing Address - Country:US
Mailing Address - Phone:551-208-1112
Mailing Address - Fax:
Practice Address - Street 1:1642 63RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-2713
Practice Address - Country:US
Practice Address - Phone:718-234-5700
Practice Address - Fax:718-234-5755
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0320061225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist