Healthcare Provider Details

I. General information

NPI: 1366411951
Provider Name (Legal Business Name): HIRAL RASIKBHAI PATEL P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343A MAIN ST
HACKENSACK NJ
07601-5804
US

IV. Provider business mailing address

224 FILIPPE CT
PARAMUS NJ
07652-5308
US

V. Phone/Fax

Practice location:
  • Phone: 201-488-0442
  • Fax:
Mailing address:
  • Phone: 201-368-3825
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberQA005533
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierQA005533
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerPHYSICAL THERAPY LICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: