Provider Demographics
NPI:1902113087
Name:PATEL, ASHISH DHIRAJ (PT)
Entity Type:Individual
Prefix:MR
First Name:ASHISH
Middle Name:DHIRAJ
Last Name:PATEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 COVENTRY AVE
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-2014
Mailing Address - Country:US
Mailing Address - Phone:516-385-2623
Mailing Address - Fax:516-224-7072
Practice Address - Street 1:66 NEW HYDE PARK RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3955
Practice Address - Country:US
Practice Address - Phone:516-233-2524
Practice Address - Fax:516-224-7072
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-09
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020027-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist