Provider Demographics
NPI:1215081336
Name:AURORA, DAMYANTI (MA)
Entity type:Individual
Prefix:MRS
First Name:DAMYANTI
Middle Name:
Last Name:AURORA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 PRUSAKOWSKI BLVD
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-3161
Mailing Address - Country:US
Mailing Address - Phone:732-725-2244
Mailing Address - Fax:
Practice Address - Street 1:33 WOOD AVE S
Practice Address - Street 2:4TH FLOOR
Practice Address - City:ISELIN
Practice Address - State:NJ
Practice Address - Zip Code:08830-2735
Practice Address - Country:US
Practice Address - Phone:732-536-0076
Practice Address - Fax:732-972-8846
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00125500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional