Healthcare Provider Details

I. General information

NPI: 1174151856
Provider Name (Legal Business Name): PURVI DESMARAIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 PILLSBURY ST STE 100
CONCORD NH
03301-3549
US

IV. Provider business mailing address

2 PILLSBURY ST STE 100
CONCORD NH
03301-3549
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License Number70905
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number34628
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: