Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 030604 | NY |
NPI | 1003067794 |
---|---|
Provider Name | Miss Paulomi Hardik Desai |
First Address | North Brunswick, NJ 08902-2700 |
Second Address | Millstone Township, NJ 08535-8103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2008 |
Last Update Date | 16/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
030604 | NEW YORK STATE LICENSE (01) | NY |