Provider Demographics
NPI:1922567635
Name:PATEL, CHINTAN
Entity Type:Individual
Prefix:
First Name:CHINTAN
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 1:4901 HARBOR BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BRIGANTINE
Mailing Address - State:NJ
Mailing Address - Zip Code:08203-1275
Mailing Address - Country:US
Mailing Address - Phone:609-287-0296
Mailing Address - Fax:
Practice Address - Street 1:4901 HARBOR BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BRIGANTINE
Practice Address - State:NJ
Practice Address - Zip Code:08203-1275
Practice Address - Country:US
Practice Address - Phone:609-287-0296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT026723225100000X
NJ40QA01753700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist