Provider Demographics
NPI:1063284669
Name:PATEL, BHARGAVI NITANT (PT)
Entity type:Individual
Prefix:
First Name:BHARGAVI
Middle Name:NITANT
Last Name:PATEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:BHARGAVI
Other - Middle Name:DASHRATHBHAI
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BPT
Mailing Address - Street 1:14011 BOYDTON PLANK RD
Mailing Address - Street 2:
Mailing Address - City:DINWIDDIE
Mailing Address - State:VA
Mailing Address - Zip Code:23841-2501
Mailing Address - Country:US
Mailing Address - Phone:804-704-2447
Mailing Address - Fax:
Practice Address - Street 1:2620A GASKINS RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23238-1402
Practice Address - Country:US
Practice Address - Phone:804-396-6753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305216006225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist