Healthcare Provider Details

I. General information

NPI: 1699036376
Provider Name (Legal Business Name): ANJALI VARMA DESAI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANJALI VIDYA VARMA M.D.

II. Dates (important events)

Enumeration Date: 05/30/2012
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MADISON AVENUE CAROL G SIMON CANCER CENTER, 2ND FLOOR
MORRISTOWN NJ
07960
US

IV. Provider business mailing address

PO BOX 416457
BOSTON MA
02241-6457
US

V. Phone/Fax

Practice location:
  • Phone: 973-971-7960
  • Fax: 973-898-1640
Mailing address:
  • Phone: 844-362-1735
  • Fax: 973-290-7495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number25MA11188900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: