Healthcare Provider Details
I. General information
NPI: 1568418028
Provider Name (Legal Business Name): SONALEE MANOJ DESAI-BARTOLI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/26/2006
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5 COLISEUM AVE
NASHUA NH
03063-3206
US
IV. Provider business mailing address
5 COLISEUM AVE
NASHUA NH
03063-3206
US
V. Phone/Fax
- Phone: 603-882-9800
- Fax: 603-882-0556
- Phone: 603-882-9800
- Fax: 603-882-0556
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | 13038 |
| License Number State | NH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | 225349 |
| License Number State | MA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207WX0009X |
| Taxonomy | Glaucoma Specialist (Ophthalmology) Physician |
| License Number | 225349 |
| License Number State | MA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207WX0009X |
| Taxonomy | Glaucoma Specialist (Ophthalmology) Physician |
| License Number | 13038 |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: