Provider Demographics
NPI:1740607316
Name:DESSALINES, NORMY (MD)
Entity Type:Individual
Prefix:
First Name:NORMY
Middle Name:
Last Name:DESSALINES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1684 OLD TRENTON RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-3205
Mailing Address - Country:US
Mailing Address - Phone:609-851-3351
Mailing Address - Fax:732-747-6001
Practice Address - Street 1:2544 NOTTINGHAM WAY
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-4104
Practice Address - Country:US
Practice Address - Phone:732-747-6600
Practice Address - Fax:732-747-6001
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-21
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09860900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine