Healthcare Provider Details

I. General information

NPI: 1033627575
Provider Name (Legal Business Name): ANJU RANI DALAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2018
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 MCAULEY DR RM 5115
YPSILANTI MI
48197-1003
US

IV. Provider business mailing address

5333 MCAULEY DR RM 5115
YPSILANTI MI
48197-1003
US

V. Phone/Fax

Practice location:
  • Phone: 734-434-4430
  • Fax: 734-434-7634
Mailing address:
  • Phone: 734-434-4430
  • Fax: 734-434-7634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number4704274363
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06201766
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: