Provider Demographics
NPI:1952156523
Name:PARIKH, KETA (PT, MSC)
Entity Type:Individual
Prefix:
First Name:KETA
Middle Name:
Last Name:PARIKH
Suffix:
Gender:F
Credentials:PT, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2723 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-2803
Mailing Address - Country:US
Mailing Address - Phone:347-240-7570
Mailing Address - Fax:
Practice Address - Street 1:2723 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-2803
Practice Address - Country:US
Practice Address - Phone:347-240-7570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049670225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist