MEDICARE: DR. KRISHNABEN PATEL PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	J1-0014362	DE

General Provider Information

NPI Number	:	1053991588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISHNABEN PATEL PT

Provider Business Mailing Address
First Line	:	3207 N ARTHUR ASHE BLVD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23230-4225
Country	:	US
Telephone Number	:	804-319-9233
Fax Number	:

Provider Business Practice Location Address
First Line	:	2620A GASKINS RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23238-1402
Country	:	US
Telephone Number	:	804-396-6753
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2021
Last Update Date	:	07/23/2021

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