Individual
DEEPTHI DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
161 JACKSON ST, LOWELL, MA 01852
(978) 937-9700
Mailing address
161 JACKSON ST, LOWELL, MA 01852-2103
(978) 937-9700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
279924
MA
390200000X
Student in an Organized Health Care Education/Training Program
L.4438R
AL
Other
Enumeration date
11/10/2016
Last updated
09/20/2019
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