Provider Demographics
NPI:1801617873
Name:PATEL, SHIVAMKUMAR ANILBHAI (PTA)
Entity type:Individual
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First Name:SHIVAMKUMAR
Middle Name:ANILBHAI
Last Name:PATEL
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Gender:M
Credentials:PTA
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Mailing Address - Street 1:2531 STEINWAY ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3788
Mailing Address - Country:US
Mailing Address - Phone:929-506-7997
Mailing Address - Fax:929-463-3149
Practice Address - Street 1:1134 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-6101
Practice Address - Country:US
Practice Address - Phone:347-218-8204
Practice Address - Fax:929-542-1222
Is Sole Proprietor?:No
Enumeration Date:2024-10-22
Last Update Date:2024-10-22
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant