Provider Demographics
NPI:1730125808
Name:PATEL, NIRALI (PHYSICALTHERAPIST)
Entity type:Individual
Prefix:MRS
First Name:NIRALI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHYSICALTHERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 OAK TREE RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1404
Mailing Address - Country:US
Mailing Address - Phone:732-494-5999
Mailing Address - Fax:732-494-5994
Practice Address - Street 1:2114 OAK TREE RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1404
Practice Address - Country:US
Practice Address - Phone:732-494-5999
Practice Address - Fax:732-494-5994
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00774700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ039755Medicare ID - Type Unspecified