Provider Demographics
NPI:1609801901
Name:PATEL, RITESH S (DC)
Entity Type:Individual
Prefix:
First Name:RITESH
Middle Name:S
Last Name:PATEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01851-1367
Mailing Address - Country:US
Mailing Address - Phone:978-458-6620
Mailing Address - Fax:978-458-6671
Practice Address - Street 1:410 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01851-1367
Practice Address - Country:US
Practice Address - Phone:978-458-6620
Practice Address - Fax:978-458-6671
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2936111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3119088OtherCIGNA
MAAA35662OtherHARVARD PILGRIM
9366886OtherPHCS
3797222OtherAETNA CLAIM PVN
7467651OtherREFERRAL PERCERTIFICATION
MAY4577901Medicare PIN
MA3119088OtherCIGNA
9366886OtherPHCS
3797222OtherAETNA CLAIM PVN