Provider Demographics
NPI:1285972398
Name:PATEL, RONAKKUMAR GOVINDBHAI
Entity type:Individual
Prefix:
First Name:RONAKKUMAR
Middle Name:GOVINDBHAI
Last Name:PATEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RONAK
Other - Middle Name:GOVINDBHAI
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:231 AUTH AVE
Mailing Address - Street 2:
Mailing Address - City:ISELIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08830-1801
Mailing Address - Country:US
Mailing Address - Phone:856-716-0605
Mailing Address - Fax:
Practice Address - Street 1:1692 OAK TREE RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2853
Practice Address - Country:US
Practice Address - Phone:856-716-0605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035886225100000X
NJ40QA01481900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist