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General NPI Number Information
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NPI Number | 1538366976
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Entity Type | Individual
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Provider Name | NEELANGANI THERESE DESOYZA MD
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Gender | Female
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 05/19/2023
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Provider Practice Location Address
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Address Line | 222 CEDAR LN STE 303
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City | TEANECK
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State | NJ
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Zip | 07666-4313
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Country | US
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Telephone | 201-871-4040
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Fax |
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Provider Business Mailing Address
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Address Line | 3 UNIVERSITY PLZ STE 205
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City | HACKENSACK
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State | NJ
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Zip | 07601-6208
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Country | US
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Telephone | 201-833-3000
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MA09778600
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License Number State | NJ
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