Provider Demographics
NPI:1316115207
Name:PATEL, RADHIKA (PHYSICAL THERAPIST ()
Entity type:Individual
Prefix:
First Name:RADHIKA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST (
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1765 SPRINGDALE RD
Mailing Address - Street 2:BUILDING A
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2177
Mailing Address - Country:US
Mailing Address - Phone:856-751-8787
Mailing Address - Fax:
Practice Address - Street 1:1765 SPRINGDALE RD
Practice Address - Street 2:BUILDING A
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2177
Practice Address - Country:US
Practice Address - Phone:856-751-8787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT23647225100000X
NJ40QA01485700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist