Organization
GAUTAM DESAI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAUTAM T DESAI MD (PRESIDENT)
(973) 361-4555
Entity
Organization
Contact information
Practice address
447 ROUTE 10, SUITE2, RANDOLPH, NJ 07869-2132
(973) 361-4555
Mailing address
447 ROUTE 10, SUITE2, RANDOLPH, NJ 07869-2132
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
07/02/2010
Last updated
07/02/2010
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