Provider Demographics
NPI:1821326000
Name:PATEL, PINAK UMESHBHAI
Entity Type:Individual
Prefix:
First Name:PINAK
Middle Name:UMESHBHAI
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 1:14127 78TH RD
Mailing Address - Street 2:APT # 2D
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3344
Mailing Address - Country:US
Mailing Address - Phone:701-640-6908
Mailing Address - Fax:
Practice Address - Street 1:2720 SURF AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-1913
Practice Address - Country:US
Practice Address - Phone:718-714-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031788225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist