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NPI 1285213256

NPI 1285213256 : VRUSHALI MAHESH DESAI : HENDERSON, NV

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General NPI Number Information
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    NPI Number           |    1285213256
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    Entity Type          |    Individual 
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    Provider Name        |    VRUSHALI MAHESH DESAI
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/06/2021
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    Last Update Date     |    07/11/2024
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Provider Practice Location Address
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    Address Line         |    3175 SAINT ROSE PKWY STE 331 
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    City                 |    HENDERSON
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    State                |    NV
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    Zip                  |    89052-3508
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    Country              |    US
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    Telephone            |    702-474-7212
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    Fax                  |    702-474-7458
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Provider Business Mailing Address
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    Address Line         |    790 REMINGTON BLVD 
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    City                 |    BOLINGBROOK
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    State                |    IL
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    Zip                  |    60440-4909
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    Country              |    US
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    Telephone            |    
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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        |    208100000X
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    Taxonomy Name        |    Physical Medicine & Rehabilitation Physician
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    License Number       |    047051
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    License Number State |    NY
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    
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    License Number State |    NV
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