Provider Demographics
NPI:1568867174
Name:PATEL, SUHALI (PT)
Entity Type:Individual
Prefix:MRS
First Name:SUHALI
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 1:14411 BUBBLING SPRING RD
Mailing Address - Street 2:
Mailing Address - City:BOYDS
Mailing Address - State:MD
Mailing Address - Zip Code:20841-4304
Mailing Address - Country:US
Mailing Address - Phone:240-480-4553
Mailing Address - Fax:301-972-1068
Practice Address - Street 1:14411 BUBBLING SPRING RD
Practice Address - Street 2:
Practice Address - City:BOYDS
Practice Address - State:MD
Practice Address - Zip Code:20841-4304
Practice Address - Country:US
Practice Address - Phone:240-480-4553
Practice Address - Fax:301-972-1068
Is Sole Proprietor?:No
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22413225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX$$$$$$$$$OtherSSN