Provider Demographics
NPI:1427292499
Name:PATEL, MINAL (PT)
Entity type:Individual
Prefix:MRS
First Name:MINAL
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3216 CRESCENT ST
Mailing Address - Street 2:APT# 2K
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-4169
Mailing Address - Country:US
Mailing Address - Phone:646-404-4648
Mailing Address - Fax:
Practice Address - Street 1:3216 CRESCENT ST
Practice Address - Street 2:APT# 2K
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-4169
Practice Address - Country:US
Practice Address - Phone:646-404-4648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023710-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist