Provider Demographics
NPI:1699139774
Name:PATEL, NEELAMBEN
Entity type:Individual
Prefix:
First Name:NEELAMBEN
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4242 JUDGE ST
Mailing Address - Street 2:5A
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-2574
Mailing Address - Country:US
Mailing Address - Phone:347-299-6136
Mailing Address - Fax:
Practice Address - Street 1:4242 JUDGE ST
Practice Address - Street 2:5A
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-2574
Practice Address - Country:US
Practice Address - Phone:347-299-6136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039203-1225100000X, 2251G0304X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics