Healthcare Provider Details

I. General information

NPI: 1255665683
Provider Name (Legal Business Name): KASHYAPI DESAI SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KASHAYPI SHAH

II. Dates (important events)

Enumeration Date: 10/02/2009
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 VINCENT CT
EAST BRUNSWICK NJ
08816-4426
US

IV. Provider business mailing address

4 VINCENT CT
EAST BRUNSWICK NJ
08816-4426
US

V. Phone/Fax

Practice location:
  • Phone: 732-721-8540
  • Fax:
Mailing address:
  • Phone: 732-721-8540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41YS00585800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: