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General NPI Number Information
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NPI Number | 1922916113
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Entity Type | Individual
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Provider Name | PRISCILLA DESANGLES JOSE
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Gender |
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 1334 MURPHY LN
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City | WINSTON SALEM
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State | NC
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Zip | 27104-3395
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Country | US
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Telephone | 561-419-5615
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Fax |
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Provider Business Mailing Address
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Address Line | 1334 MURPHY LN
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City | WINSTON SALEM
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State | NC
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Zip | 27104-3395
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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 | A8463
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License Number State | NC
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