Provider Demographics
NPI:1851515134
Name:PATEL, AMI R (PT)
Entity Type:Individual
Prefix:MRS
First Name:AMI
Middle Name:R
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 1:1300 FULTON CIR
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2446
Mailing Address - Country:US
Mailing Address - Phone:267-574-3226
Mailing Address - Fax:267-560-5092
Practice Address - Street 1:11596 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-3032
Practice Address - Country:US
Practice Address - Phone:215-677-8200
Practice Address - Fax:215-969-2681
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018511225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist