Provider Demographics
NPI:1851831770
Name:PATEL, DARSHAN
Entity Type:Individual
Prefix:
First Name:DARSHAN
Middle Name:
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 1:1431 PAWTUCKET BLVD
Mailing Address - Street 2:29
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-1072
Mailing Address - Country:US
Mailing Address - Phone:978-259-8561
Mailing Address - Fax:
Practice Address - Street 1:1431 PAWTUCKET BLVD
Practice Address - Street 2:29
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-1072
Practice Address - Country:US
Practice Address - Phone:978-259-8561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1287306225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist