Organization
IDAHO MEMORY & AGING CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ABHILASH K DESAI M.D. (MEDICAL DIRECTOR)
(617) 922-4957
Entity
Organization
Contact information
Practice address
413 N ALLUMBAUGH ST, STE# 101, BOISE, ID 83704-9212
(617) 922-4957
Mailing address
413 N ALLUMBAUGH ST, STE# 101, BOISE, ID 83704-9212
(617) 922-4957
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
M-12079
ID
Other
Enumeration date
06/14/2013
Last updated
07/19/2013
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