Provider Demographics
NPI:1841585908
Name:BALSARA, SAKINA MUSTAFA
Entity Type:Individual
Prefix:MRS
First Name:SAKINA
Middle Name:MUSTAFA
Last Name:BALSARA
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 1:129 PEAR TREE LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08823-1405
Mailing Address - Country:US
Mailing Address - Phone:732-354-3725
Mailing Address - Fax:
Practice Address - Street 1:129 PEAR TREE LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:NJ
Practice Address - Zip Code:08823-1405
Practice Address - Country:US
Practice Address - Phone:732-354-3725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01398400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist