Provider Demographics
NPI:1063765071
Name:DESAI, URVI
Entity type:Individual
Prefix:
First Name:URVI
Middle Name:
Last Name:DESAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 MAPLE CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-1922
Mailing Address - Country:US
Mailing Address - Phone:732-325-4610
Mailing Address - Fax:
Practice Address - Street 1:155 RAYMOND RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-9608
Practice Address - Country:US
Practice Address - Phone:732-329-1181
Practice Address - Fax:732-329-1171
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034807225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist