Provider Demographics
NPI:1578081642
Name:DARYANANI, PRASNA G,
Entity Type:Individual
Prefix:MS
First Name:PRASNA
Middle Name:G,
Last Name:DARYANANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 805
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-0805
Mailing Address - Country:US
Mailing Address - Phone:732-668-1784
Mailing Address - Fax:609-987-8888
Practice Address - Street 1:13124 E RUN DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-1236
Practice Address - Country:US
Practice Address - Phone:732-668-1784
Practice Address - Fax:609-987-8888
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175T00000X, 225800000X, 372500000X, 372600000X, 376J00000X
NJD07196336761662172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No175T00000XOther Service ProvidersPeer Specialist
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker