Individual
JAYANT DOLATRAY DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16521 HILLSIDE AVE, JAMAICA, NY 11432-4134
(718) 657-1717
(718) 657-7748
Mailing address
16521 HILLSIDE AVE, JAMAICA, NY 11432-4134
(718) 657-1717
(718) 657-7748
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
144734
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0832504
—
NY
01
—
144736
STATE LICENSE
NY
Enumeration date
12/01/2006
Last updated
03/07/2023
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