MEDICARE: BHAVINIBEN 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	034542	NY

General Provider Information

NPI Number	:	1710387865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BHAVINIBEN PATEL PT

Provider Business Mailing Address
First Line	:	1762 MCDONALD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-6907
Country	:	US
Telephone Number	:	718-758-5161
Fax Number	:	718-758-5160

Provider Business Practice Location Address
First Line	:	1762 MCDONALD AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-6907
Country	:	US
Telephone Number	:	718-758-5161
Fax Number	:	718-758-5160

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

Provider Enumeration Date	:	08/26/2014
Last Update Date	:	08/26/2014

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