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NPI Code Detail

MEDICARE: DIVYESH PATEL MSPT

MEDICARE:   DIVYESH  PATEL  MSPT
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
1225100000XPhysical Therapist022421NY
22251P0200XPediatric Physical Therapist022421NY

General Provider Information

NPI Number : 1528376472
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIVYESH PATEL MSPT
Provider Business Mailing Address
First Line : 406 COURT ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11231-4206
Country : US
Telephone Number : 646-275-0358
Fax Number :
Provider Business Practice Location Address
First Line : 406 COURT ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11231-4206
Country : US
Telephone Number : 646-275-0358
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2010
Last Update Date : 09/14/2010

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Directions to “ DIVYESH PATEL MSPT” Practice Location

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