Provider Demographics
NPI:1487830824
Name:PATEL, PURVI R (PT)
Entity Type:Individual
Prefix:
First Name:PURVI
Middle Name:R
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 1:1715 KENNEDY BLVD
Mailing Address - Street 2:APT. 1F
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-6349
Mailing Address - Country:US
Mailing Address - Phone:201-978-6903
Mailing Address - Fax:
Practice Address - Street 1:115 W CENTURY RD
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1450
Practice Address - Country:US
Practice Address - Phone:201-265-3993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA009825002251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics