Healthcare Provider Details

I. General information

NPI: 1285073981
Provider Name (Legal Business Name): NJ DOCTORS HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 06/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 GAWRON CT
PARLIN NJ
08859-4116
US

IV. Provider business mailing address

420 GAWRON CT
PARLIN NJ
08859-4116
US

V. Phone/Fax

Practice location:
  • Phone: 901-270-5654
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: DR. AASHISH DESAI
Title or Position: OWNER/ PHYSICIAN
Credential: M.D.
Phone: 901-270-5654