Healthcare Provider Details

I. General information

NPI: 1013845999
Provider Name (Legal Business Name): JUHI HETAL DESAI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12221 SAINT CHARLES ROCK RD
BRIDGETON MO
63044-2502
US

IV. Provider business mailing address

1 KNIGHTSBRIDGE PL
JACKSON NJ
08527-1271
US

V. Phone/Fax

Practice location:
  • Phone: 314-784-9702
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: