Provider Demographics
NPI:1710298633
Name:PATEL, LIPEE VIJAYKUMAR (PT)
Entity Type:Individual
Prefix:
First Name:LIPEE
Middle Name:VIJAYKUMAR
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 1:225 SAINT PAULS AVE APT 6D
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3723
Mailing Address - Country:US
Mailing Address - Phone:347-821-7692
Mailing Address - Fax:
Practice Address - Street 1:1642 63RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-2713
Practice Address - Country:US
Practice Address - Phone:718-234-5700
Practice Address - Fax:718-234-5755
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031385225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist