Provider Demographics
NPI:1730122243
Name:DESAI, NILA (RPT)
Entity Type:Individual
Prefix:
First Name:NILA
Middle Name:
Last Name:DESAI
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 ROBIN RD
Mailing Address - Street 2:SUITE 118
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1449
Mailing Address - Country:US
Mailing Address - Phone:201-225-1511
Mailing Address - Fax:201-225-9731
Practice Address - Street 1:205 ROBIN RD
Practice Address - Street 2:SUITE 118
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1449
Practice Address - Country:US
Practice Address - Phone:201-225-1511
Practice Address - Fax:201-225-9731
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00509500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist