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General NPI Number Information
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NPI Number | 1235208786
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Entity Type | Individual
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Provider Name | SUJAL DESAI P.T.
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Gender | Female
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 585 MAIN ST
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-1104
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Country | US
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Telephone | 732-636-5151
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Fax | 732-602-0046
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Provider Business Mailing Address
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Address Line | 31 SPEAR ST
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City | PISCATAWAY
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State | NJ
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Zip | 08854-2312
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Country | US
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Telephone | 732-805-1999
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA00595300
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License Number State | NJ
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