Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 0120331 | NY |
NPI | 1003430083 |
---|---|
Provider Name | Rimabahen Patel |
First Address | Orchard Park, NY 14127-4861 |
Second Address | Rochester, NY 14607-1500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2020 |
Last Update Date | 04/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GM05227G | (05) | NY |