Provider Demographics
NPI:1760574693
Name:PATEL, RAKSHA BHARAT (PT)
Entity Type:Individual
Prefix:MRS
First Name:RAKSHA
Middle Name:BHARAT
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:PO BOX 5636
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08875-5636
Mailing Address - Country:US
Mailing Address - Phone:732-873-0875
Mailing Address - Fax:732-873-1540
Practice Address - Street 1:17 CLYDE RD STE 102
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5041
Practice Address - Country:US
Practice Address - Phone:732-873-0875
Practice Address - Fax:732-873-1540
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00390900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0464706OtherAETNA (BUSINESS)
NJANC1746OtherOXFORD
NJ080003909NJ01OtherANTHEM
NJ85600OtherAETNA (INDIVIDUAL)
NJANC1746OtherOXFORD