Provider Demographics
NPI:1376953208
Name:MISTRY, DARSHANABAHEN J (NP)
Entity Type:Individual
Prefix:
First Name:DARSHANABAHEN
Middle Name:J
Last Name:MISTRY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CLAIR ST
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2618
Mailing Address - Country:US
Mailing Address - Phone:973-473-3163
Mailing Address - Fax:
Practice Address - Street 1:20 CLAIR ST
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2618
Practice Address - Country:US
Practice Address - Phone:973-473-3163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00431900363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health