Individual
DR. AMITA DESAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
718 TEANECK RD, HOLY NAME HOSPITAL, TEANECK, NJ 07666-4245
(201) 833-3000
Mailing address
25 STEWART ST, DEMAREST, NJ 07627-2002
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA06578700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037470
MEDICARE PTAN
NJ
Enumeration date
08/09/2005
Last updated
08/06/2010
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