Provider Demographics
NPI:1821869108
Name:PATEL, ASHVINKUMAR (PT)
Entity Type:Individual
Prefix:
First Name:ASHVINKUMAR
Middle Name:
Last Name:PATEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 BROADWAY MALL
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-1919
Mailing Address - Country:US
Mailing Address - Phone:607-324-9344
Mailing Address - Fax:607-324-9345
Practice Address - Street 1:55 BROADWAY MALL
Practice Address - Street 2:
Practice Address - City:HORNELL
Practice Address - State:NY
Practice Address - Zip Code:14843-1919
Practice Address - Country:US
Practice Address - Phone:607-324-9344
Practice Address - Fax:607-324-9345
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY048564OtherNYS LICENSE