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General NPI Number Information
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NPI Number | 1891289062
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Entity Type | Individual
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Provider Name | KRUPA KOMAL PATEL
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Gender | Female
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 11/13/2019
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Provider Practice Location Address
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Address Line | 1833 HARD RD
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City | COLUMBUS
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State | OH
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Zip | 43235-5927
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Country | US
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Telephone | 330-780-6006
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Fax |
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Provider Business Mailing Address
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Address Line | 4616 NAPA OAK DR
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City | CHARLOTTE
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State | NC
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Zip | 28216-8026
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Country | US
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Telephone | 330-780-6006
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | P18739
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | J1-0003903
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License Number State | DE
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