Provider Demographics
NPI:1720729742
Name:PATEL, KAJAL (DPT)
Entity Type:Individual
Prefix:
First Name:KAJAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:934 MORGAN RUN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2164
Mailing Address - Country:US
Mailing Address - Phone:931-259-0733
Mailing Address - Fax:
Practice Address - Street 1:1838 GREENE TREE RD STE 290
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-7108
Practice Address - Country:US
Practice Address - Phone:410-653-9813
Practice Address - Fax:410-653-9815
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29668225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist