Provider Demographics
NPI:1497562938
Name:PATEL, RUTVI DIPAKKUMAR
Entity type:Individual
Prefix:
First Name:RUTVI
Middle Name:DIPAKKUMAR
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 1:102 NELSON AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-4597
Mailing Address - Country:US
Mailing Address - Phone:571-337-8686
Mailing Address - Fax:
Practice Address - Street 1:13630 MAPLE AVE STE 2J
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3868
Practice Address - Country:US
Practice Address - Phone:347-245-6101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051511261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy