MEDICARE: HIMANSHU P DESAI M.D.

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	207RG0100X	Gastroenterology Physician	MD069935L	PA
2	207RG0100X	Gastroenterology Physician	25MA11198600	NJ
3	207RG0100X	Gastroenterology Physician	35066332D	OH
4	207RG0100X	Gastroenterology Physician	17863	WV

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780681825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIMANSHU P DESAI M.D.

Provider Business Mailing Address
First Line	:	2 CAPITAL WAY STE 487
Second Line	:
City	:	PENNINGTON
State	:	NJ
Zip	:	08534-2521
Country	:	US
Telephone Number	:	609-818-1900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 CAPITAL WAY STE 487
Second Line	:
City	:	PENNINGTON
State	:	NJ
Zip	:	08534-2521
Country	:	US
Telephone Number	:	609-818-1900
Fax Number	:

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	01/13/2023

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Directions to “ HIMANSHU P DESAI M.D.” Practice Location

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