Individual
PURVI D DESAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
136 MOUNTAINVIEW BLVD, BASKING RIDGE, NJ 07920-3444
(908) 542-3000
Mailing address
136 MOUNTAINVIEW BLVD, BASKING RIDGE, NJ 07920-3444
(908) 542-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00246500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MP00246500
NJ LIC
NJ
Enumeration date
08/25/2011
Last updated
04/22/2022
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