Provider Demographics
NPI:1003067794
Name:DESAI, PAULOMI HARDIK (PT,DPT)
Entity Type:Individual
Prefix:MISS
First Name:PAULOMI
Middle Name:HARDIK
Last Name:DESAI
Suffix:
Gender:F
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LYNN CT
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-2700
Mailing Address - Country:US
Mailing Address - Phone:732-325-9005
Mailing Address - Fax:
Practice Address - Street 1:525 ROUTE 33
Practice Address - Street 2:
Practice Address - City:MILLSTONE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08535-8103
Practice Address - Country:US
Practice Address - Phone:212-370-5551
Practice Address - Fax:212-370-5559
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030604225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY030604OtherNEW YORK STATE LICENSE