MEDICARE: DR. NINAD DESAI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0207X	Pediatric Hematology & Oncology Physician	210284	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003892902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NINAD DESAI MD

Provider Business Mailing Address
First Line	:	31 HICKS LN
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11024-2026
Country	:	US
Telephone Number	:	516-487-0929
Fax Number	:	718-245-4107

Provider Business Practice Location Address
First Line	:	451 CLARKSON AVE
Second Line	:	KINGS COUNTY HOSPITAL CENTER; B 6202
City	:	BROOKLYN
State	:	NY
Zip	:	11203-2057
Country	:	US
Telephone Number	:	718-245-4105
Fax Number	:	718-245-4107

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	07/08/2007

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