Provider Demographics
NPI:1508570185
Name:PATEL, TEJAS U (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:TEJAS
Middle Name:U
Last Name:PATEL
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 S PARK PL # 1406S
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4911
Mailing Address - Country:US
Mailing Address - Phone:718-496-4418
Mailing Address - Fax:
Practice Address - Street 1:1406 S PARK PL
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-4911
Practice Address - Country:US
Practice Address - Phone:718-496-4418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041195208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty