Provider Demographics
NPI:1811007453
Name:PATEL, KUNAL M (PT)
Entity type:Individual
Prefix:
First Name:KUNAL
Middle Name:M
Last Name:PATEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:619 LISA PL
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-5581
Mailing Address - Country:US
Mailing Address - Phone:732-422-1721
Mailing Address - Fax:
Practice Address - Street 1:1175 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:CARTERET
Practice Address - State:NJ
Practice Address - Zip Code:07008-1536
Practice Address - Country:US
Practice Address - Phone:732-541-2233
Practice Address - Fax:732-541-2237
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ40QA01092500OtherLICENSE #