Healthcare Provider Details

I. General information

NPI: 1831542372
Provider Name (Legal Business Name): ROMA DESAI OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2016
Last Update Date: 03/21/2026
Certification Date: 03/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6020 MEADOWRIDGE CENTER DR
ELKRIDGE MD
21075-6528
US

IV. Provider business mailing address

2661 RIVA RD STE 1030
ANNAPOLIS MD
21401-7131
US

V. Phone/Fax

Practice location:
  • Phone: 410-872-1600
  • Fax:
Mailing address:
  • Phone: 667-354-5528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTA2545
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: