Healthcare Provider Details

I. General information

NPI: 1083952436
Provider Name (Legal Business Name): NEEL SUNIL DESAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2013
Last Update Date: 10/11/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 E RIDGEWOOD AVE STE 415S
PARAMUS NJ
07652-3917
US

IV. Provider business mailing address

5410 MARYLAND WAY STE 400
BRENTWOOD TN
37027-8087
US

V. Phone/Fax

Practice location:
  • Phone: 855-212-2273
  • Fax:
Mailing address:
  • Phone: 855-212-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number25MA09280200
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD464794
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: