Provider Demographics
NPI:1003182932
Name:DESENA, JAMIE L (DPT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:DESENA
Suffix:
Gender:F
Credentials:DPT
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Other - First Name:
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Mailing Address - Street 1:11 EAGLE ROCK AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3167
Mailing Address - Country:US
Mailing Address - Phone:973-726-7400
Mailing Address - Fax:973-726-7440
Practice Address - Street 1:13A MAIN ST
Practice Address - Street 2:SUITE 4
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1941
Practice Address - Country:US
Practice Address - Phone:973-726-7400
Practice Address - Fax:973-726-7440
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2018-01-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NM40QA01437400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist