Provider Demographics
NPI:1659923902
Name:PATEL, AKASHKUMAR DINESHBHAI
Entity Type:Individual
Prefix:
First Name:AKASHKUMAR
Middle Name:DINESHBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 N BROOME AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-2105
Mailing Address - Country:US
Mailing Address - Phone:631-746-1492
Mailing Address - Fax:
Practice Address - Street 1:1799 BRENTWOOD RD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-4611
Practice Address - Country:US
Practice Address - Phone:631-388-5797
Practice Address - Fax:631-388-5980
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011641-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant