Provider Demographics
NPI:1477894996
Name:PATEL, KIRANBEN (PT)
Entity Type:Individual
Prefix:MRS
First Name:KIRANBEN
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ROUTE 211 E
Mailing Address - Street 2:SUITE 12
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2122
Mailing Address - Country:US
Mailing Address - Phone:845-381-1164
Mailing Address - Fax:845-381-1807
Practice Address - Street 1:400 ROUTE 211 E
Practice Address - Street 2:SUITE 12
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2122
Practice Address - Country:US
Practice Address - Phone:845-381-1164
Practice Address - Fax:845-381-1807
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032737225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist