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General NPI Number Information
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NPI Number | 1972151793
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Entity Type | Individual
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Provider Name | SHAIL PATEL PT
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Gender | Male
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 3075 VETERANS MEMORIAL HWY STE 101
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City | RONKONKOMA
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State | NY
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Zip | 11779-7600
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Country | US
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Telephone | 631-805-2850
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Fax |
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Provider Business Mailing Address
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Address Line | 130 LAIDLAW AVE APT 2
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City | JERSEY CITY
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State | NJ
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Zip | 07306-2196
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Country | US
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Telephone | 551-263-4634
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 042803
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License Number State | NY
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