Provider Demographics
NPI:1194162602
Name:PATEL, FORAM R (MD)
Entity type:Individual
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First Name:FORAM
Middle Name:R
Last Name:PATEL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:19 SAINT PAULS AVE
Mailing Address - Street 2:APT 3
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1644
Mailing Address - Country:US
Mailing Address - Phone:718-864-1966
Mailing Address - Fax:201-595-0931
Practice Address - Street 1:64 FULTON ST
Practice Address - Street 2:RM 303
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-2756
Practice Address - Country:US
Practice Address - Phone:718-864-1966
Practice Address - Fax:201-595-0931
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-24
Last Update Date:2021-06-25
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Provider Licenses
StateLicense IDTaxonomies
NY036033225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist