Provider Demographics
NPI:1316389224
Name:DESAI, SALONI (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SALONI
Middle Name:
Last Name:DESAI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 CEDAR LANE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666
Mailing Address - Country:US
Mailing Address - Phone:201-836-7664
Mailing Address - Fax:201-836-5710
Practice Address - Street 1:780 CEDAR LANE
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:201-836-7664
Practice Address - Fax:201-836-5710
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00313800363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant