Provider Demographics
NPI:1477813111
Name:PATEL, JANKI R
Entity type:Individual
Prefix:
First Name:JANKI
Middle Name:R
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 MOLA BLVD
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-1343
Mailing Address - Country:US
Mailing Address - Phone:973-358-5500
Mailing Address - Fax:973-358-5501
Practice Address - Street 1:93-95 MAIN STREET
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07505
Practice Address - Country:US
Practice Address - Phone:973-358-5500
Practice Address - Fax:973-358-5501
Is Sole Proprietor?:No
Enumeration Date:2012-05-28
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034906-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist