Provider Demographics
NPI:1710256649
Name:PATEL, JANKI (PT)
Entity Type:Individual
Prefix:
First Name:JANKI
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 1:174 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4803
Mailing Address - Country:US
Mailing Address - Phone:914-328-8077
Mailing Address - Fax:914-328-6083
Practice Address - Street 1:26440 FM 1093 RD STE A180
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-7213
Practice Address - Country:US
Practice Address - Phone:281-347-8900
Practice Address - Fax:281-347-8906
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033705225100000X
TX1356519225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1356519OtherPT LICENSE
NYA400073917Medicare PIN
NYA400061363Medicare PIN
NYG400076909Medicare PIN