Healthcare Provider Details

I. General information

NPI: 1760628556
Provider Name (Legal Business Name): PALVI PATEL DPT,MA, BS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2008
Last Update Date: 12/13/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 JEFFERSON BLVD
STATEN ISLAND NY
10312-3329
US

IV. Provider business mailing address

11 ST JAMES ST
MONROE TOWNSHIP NJ
08831-8681
US

V. Phone/Fax

Practice location:
  • Phone: 929-284-3318
  • Fax:
Mailing address:
  • Phone: 347-885-8813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number026329-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number026329-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: