Healthcare Provider Details

I. General information

NPI: 1720514169
Provider Name (Legal Business Name): DHRUVY PATEL PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DHRUVY SHAH

II. Dates (important events)

Enumeration Date: 05/04/2017
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 IRVING ST NW
WASHINGTON DC
20010-2921
US

IV. Provider business mailing address

1400 IRVING ST NW APT 413
WASHINGTON DC
20010-2850
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-1566
  • Fax:
Mailing address:
  • Phone: 815-603-4594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number872027
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: