Healthcare Provider Details

I. General information

NPI: 1275451593
Provider Name (Legal Business Name): ANJLI DALSANIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 LAKE ST
DALLAS PA
18612-1090
US

IV. Provider business mailing address

917 OAKWOOD DR
SOUTH ABINGTON TOWNSHIP PA
18411-9725
US

V. Phone/Fax

Practice location:
  • Phone: 570-674-6400
  • Fax:
Mailing address:
  • Phone: 570-604-2819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN752037
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: