Provider Demographics
NPI:1902192867
Name:PALLAVI PATEL OT P.C
Entity Type:Organization
Organization Name:PALLAVI PATEL OT P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUAPTIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PALLAVI
Authorized Official - Middle Name:K
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:718-926-8994
Mailing Address - Street 1:8326 251ST ST
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-2113
Mailing Address - Country:US
Mailing Address - Phone:718-926-8994
Mailing Address - Fax:718-343-3178
Practice Address - Street 1:8326 251ST ST
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-2113
Practice Address - Country:US
Practice Address - Phone:718-926-8994
Practice Address - Fax:718-343-3178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013810252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency