Healthcare Provider Details

I. General information

NPI: 1831610534
Provider Name (Legal Business Name): VAMAN KANU PATEL PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 12/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 COVENTRY CT
DOVER DE
19901
US

IV. Provider business mailing address

16 COVENTRY CT
DOVER DE
19901-6552
US

V. Phone/Fax

Practice location:
  • Phone: 302-943-8102
  • Fax:
Mailing address:
  • Phone: 302-943-8102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License NumberJ1-0003770
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: