Provider Demographics
NPI:1245968643
Name:PATEL, SHIVANI JAYANTIBHAI (DC)
Entity type:Individual
Prefix:DR
First Name:SHIVANI
Middle Name:JAYANTIBHAI
Last Name:PATEL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3686 WASHINGTON ST APT 2315
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3685
Mailing Address - Country:US
Mailing Address - Phone:334-324-9273
Mailing Address - Fax:
Practice Address - Street 1:138 DODGE ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-1866
Practice Address - Country:US
Practice Address - Phone:978-810-6799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3803111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor