MEDICARE: NISHA PATEL

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	390200000X	Student in an Organized Health Care Education/Training Program
2	225X00000X	Occupational Therapist	11431	OH

General Provider Information

NPI Number	:	1861026866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NISHA PATEL

Provider Business Mailing Address
First Line	:	1065 HARTFORD LN
Second Line	:
City	:	LONDON
State	:	OH
Zip	:	43140-8427
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 OLENTANGY RIVER RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-3450
Country	:	US
Telephone Number	:	614-457-1100
Fax Number	:

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

Provider Enumeration Date	:	02/27/2020
Last Update Date	:	05/17/2021

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Directions to “ NISHA PATEL ” Practice Location

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