Provider Demographics
NPI:1477322998
Name:PATEL, SHIVANI KIRAN (DPT)
Entity Type:Individual
Prefix:DR
First Name:SHIVANI
Middle Name:KIRAN
Last Name:PATEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 4TH ST NE APT 304
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-7094
Mailing Address - Country:US
Mailing Address - Phone:229-200-9762
Mailing Address - Fax:
Practice Address - Street 1:1301 PENNSYLVANIA AVE SE STE 100
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3027
Practice Address - Country:US
Practice Address - Phone:202-455-8644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29785225100000X
VA2305215954225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist