Provider Demographics
NPI:1356196786
Name:ANISH DESAI INTERNAL MEDICINE PLLC
Entity type:Organization
Organization Name:ANISH DESAI INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ANISH
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-630-6641
Mailing Address - Street 1:6201 15TH AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-5411
Mailing Address - Country:US
Mailing Address - Phone:732-630-6641
Mailing Address - Fax:
Practice Address - Street 1:6201 15TH AVE STE 305
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-5411
Practice Address - Country:US
Practice Address - Phone:732-630-6641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty